Ultrasound-guided versus computed tomography-scan guided biopsy of pleural-based lung lesions.
BACKGROUND
Computed tomography (CT) guided biopsies have long been the standard technique to obtain tissue from the thoracic cavity and is traditionally performed by interventional radiologists. Ultrasound (US) guided biopsy of pleural-based lesions, performed by pulmonologists is gaining popularity and has the advantage of multi-planar imaging, real-time technique, and the absence of radiation exposure to patients. In this study, we aim to determine the diagnostic accuracy, the time to diagnosis after the initial consult placement, and the complications rates between the two different modalities.


METHODS
A retrospective study of electronic medical records was done of patients who underwent CT-guided biopsies and US-guided biopsies for pleural-based lesions between 2005 and 2014 and the data collected were analyzed for comparing the two groups.


RESULTS
A total of 158 patients underwent 162 procedures during the study period. 86 patients underwent 89 procedures in the US group, and 72 patients underwent 73 procedures in the CT group. The overall yield in the US group was 82/89 (92.1%) versus 67/73 (91.8%) in the CT group (P = 1.0). Average days to the procedure was 7.2 versus 17.5 (P = 0.00001) in the US and CT group, respectively. Complication rate was higher in CT group 17/73 (23.3%) versus 1/89 (1.1%) in the US group (P < 0.0001).


CONCLUSIONS
For pleural-based lesions the diagnostic accuracy of US guided biopsy is similar to that of CT-guided biopsy, with a lower complication rate and a significantly reduced time to the procedure.
Department of Pulmonary and Critical Care, Veteran Affairs Medical Center, George Washington University, Washington, DC, USA.
Rahul
R
Khosla
Department of Pulmonary and Critical Care, Veterans Affairs Medical Center, George Washington University, Washington, DC, USA.
Anna W
AW
McLean
Department of Pulmonary and Critical Care, Veterans Affairs Medical Center, George Washington University, Washington, DC, USA.
Jessica A
JA
Smith
Computed tomography-guided; pleural-based lesions; ultrasound guided