Learning objectives
Report our experience with percutaneous transthoracic biopsies and hook wires positioning in paediatric patients and evaluate safety and efficacy of all procedures.
Background
Percutaneous transthoracic procedures are commonly performed in adult patients with lung nodules or mediastinal masses.
Needle biopsies permit to obtain an histological diagnosis which is fundamental to improve therapeutic planning and determine the prognosis of patients.
Hook wire positioning is used to spare lung tissue when surgical resection of nodule is required.
Even different studies confirm their safety and feasibility in adults,
there is little literature about transthoracic procedures in paediatric population.
Paediatric thoracic pathology is routinely detected using multidetector CT,
which permits depiction also...
Findings and procedure details
Before all procedures all patients were evaluated by a multidisciplinary team composed by radiologist,
oncologic paediatrics,
paediatric surgeon and anaesthesiologist.
A thorax CT scan or PET-CT scan [18] was performed for each patient as previous imaging investigation.
Informed consensus was obtained from parents and children were involved in the explication of the procedure.
This was fundamental for the collaboration of little patients during procedures only under local anaesthesia.
For each patient coagulation profile was checked (platelets ≥ 25000 mm3 and INR <1,5).
For CT-guided procedures...
Conclusion
In our experience,
percutaneous transthoracic procedures are effective in paediatric patients,
without significant complications.
Sedation is not always required for biopsies and the hook wired positioning can be performed using the same sedation for surgery; so,
these procedures don’t require necessary additional sedation if radiologists,
anaesthetists and surgeons collaborate into a multidisciplinary management of patients.
For justified indications low dose radiation protocol can be safely used in paediatric population,
adapting tube current and voltage selection and using iterative reconstruction algorithms,
in according to the main...
Personal information
A.
Pittaro MD
Radiology Residency Program
University of Padova
Policlinico Universitario
Via Giustiniani,
2 - 35128 Padova,
Italy
[email protected]
C.
Dengo MD
Radiology Residency Program
University of Padova
Policlinico Universitario
Via Giustiniani,
2 - 35128 Padova,
Italy
[email protected]
M.
Battistel MD
Department of Radiology,
University of Padova
Policlinico Universitario
Via Giustiniani,
2 - 35128 Padova,
Italy
G.
Barbiero MD
Department of Radiology,
University of Padova
Policlinico Universitario
Via Giustiniani,
2 - 35128 Padova,
Italy
T.
Toffolutti MD
Department of Radiology,
University of Padova
Policlinico Universitario...
References
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Clinical application of CT and CT-guided percutaneous transthoracic needle biopsy in patients
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