Keywords:
Neoplasia, Calcifications / Calculi, CAD, Biopsy, Ablation procedures, MR, CT, Thorax, Interventional non-vascular, Cardiac
Authors:
G. Asafu Adjaye Frimpong1, E. Aboagye1, P. Amankwah2, N. K. Abaidoo2; 1Kumasi, Ashanti/GH, 2Kumasi/GH
DOI:
10.26044/ecr2019/C-1837
Methods and materials
Patient population
This retrospective study involved patients who were referred to our centre (Spectra Health Imaging and Interventional Radiology) for CT-guided thoracic biopsies from January 2010 to December 2017.
Patients who required significant sedation or anaesthesia were excluded from the study.
CT-guided Thoracic Biopsy Procedure
Patients were first taken through the process of breath holding before the procedure.
A pre-biopsy scan of the affected organ was then obtained using 64-slice multi-detector computed tomography scanner (Somatom Definition AS; Siemens,
Erlagen,
Germany),
Somatom Emotion eco (16-slice configuration,
Siemens,
Erlagen,
Germany) and GE Light Speed VCT 64-slice (GE healthcare,
Milwaukee,
USA).
Biopsies were then performed with the patient placed either supine,
prone or in a lateral decubitus position to facilitate sampling of the lesion from a position closest to the body surface.
Intravenous iodinated contrast (OmnipaqueTM 350mgI/ml) was administered when appropriate.
Under aseptic conditions,
local anaesthesia with 1% lidocaine (5-10mL) was used.
Under CT guidance,
the thoracic biopsies were performed with a 16-gauge (Gauge Size and Needle Length=16g x 16cm; length of Sample Notch=1.9cm) BARD Coaxial system (Bard Peripheral Vascular,
Inc.) for deep structures and 14-gauge (Palium Needle,
14G x 100 mm,
M.D.L.
Srl-Via Tavani 1A) for superficial and chest wall lesions.
All patients underwent tissue core biopsies,
in which only one puncture was made,
and an average of 4-6 specimens taken with the coaxial system.
None of the mediastinal biopsies required trans-pulmonary approach.
Post-biopsy care
Post-biopsy CT scan was performed immediately for all the cases using contrast.
Patients without post-biopsy complications were made to lie down for 30 minutes in a lateral decubitus position.
During this time,
patients’ blood pressure and pulse were checked every 10 minutes,
and also analgesics and/or antibiotics were given depending on patient’s pain level or risk factors respectively.
Patients without post-biopsy complications were discharged after 30 minutes,
and given a hot line to call in case of any complications.
There was a follow-up call by a nurse after 24 hours to inquire about any complications and the general condition of the patient.
During the follow-up call,
patients were asked whether they had experienced delayed symptoms such as worsening pain,
generalized discomfort and shortness of breath.
A flow chart showing the proposed patient treatment algorithm after CT-guided thoracic biopsy is shown in figure 1.