Type:
Educational Exhibit
Keywords:
Interventional non-vascular, Lung, Oncology, CT, Biopsy, Chemotherapy, Neoplasia, Pathology
Authors:
R. Chaganti, C. Zhou, J. Hanson
DOI:
10.26044/ranzcr2022/R-0195
Learning objectives
”Enough is not enough” - under what circumstances might seemingly diagnostic CT guided percutaneous transthoracic lung needle biopsy (PTLNB) be insufficient for optimal patient management?
In 20-30% of PTLNB procedures the pathologic material obtained may be classified as nondiagnostic [1].
Furthermore, in 10-20% of PTLNB procedures that are diagnostic of malignancy, the results may be insufficient to direct optimal targeted therapy, [2-4]. This is largely because of development of specific targeted therapies and immunotherapies for various tumours, which increasingly require comprehensive immunohistochemical (IHC) and molecular studies, and place greater demand for adequate needle tissue sampling.
The purpose of this exhibit is to discuss these diagnostic limitations for PTLNB.
The presented material is partly based on retrospective study of the diagnostic performance and clinical utility PTLNB performed at regional thoracic oncology centre (CCLHD, NSW).
The aim is to increase awareness of procedural radiologists to the developing field of tumour immunohistochemistry and molecular characterisation, such that potential problematic cases may be identified prospectively and lead to modified PTLNB techniques.