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Medical Oncology

, 34:17 | Cite as

Extra-pleuric coaxial system for CT-guided percutaneous fine-needle aspiration biopsy (FNAB) of small (≤20 mm) lung nodules: a novel technique using multiplanar reconstruction (MPR) images

  • Raffaella CapassoEmail author
  • Rita Nizzoli
  • Marcello Tiseo
  • Giuseppe Pedrazzi
  • Luca Brunese
  • Antonio Rotondo
  • Massimo De Filippo
Original Paper
Part of the following topical collections:
  1. New Advances in Interventional Oncology: State of the Art

Abstract

The aim of the study is to present the diagnostic feasibility, usefulness, and safety of a novel technique for coaxial CT-guided fine-needle aspiration biopsy of small (≤20 mm in diameter) lung nodules. A 18-gauge (G) (1.2 × 40 mm) needle is inserted through the skin in the depth of the thoracic wall tissues remaining outside the pleura. Its positioning is planned and adjusted using multiplanar reconstruction (MPR) images along the 18-G guide needle axis tracing a reference outline extended from the needle tip to the target nodule. When the insertion of the 18-G extra-pleuric needle (EPN) proves to be precise, a 22-G Chiba needle is then passed through the outer 18-G EPN until it reaches the thoracic lesion for the sampling procedure. Patient population included 153 males and 94 females, with a mean age of 61.3 ± 21.6 years. Mean nodule diameter was 14.1 ± 2.2 mm. The lesion depth from pleural plane ranged from 0 mm to 127 mm. An average of 1.29 aspirates were performed per lesion. The most common complication was pneumothorax in 27 cases; there were no cases of PNX requiring chest tube insertion. Intrapulmonary bleeding along the needle track was observed in 32 patients. Exploiting the advantage of MPR images, our novel technique of extra-pleuric coaxial system with a 18-G EPN allows the operator to multiple samplings of small (≤20 mm) target lesions in various locations with a thinner (22-G Chiba) needle, thus reducing the degree of pleural, parenchymal, or adjacent organs damage.

Keywords

Coaxial technique Lung biopsy CT guidance Small nodule Pneumothorax MPR 

Abbreviations

CT

Computed tomography

EPN

Extra-pleuric needle

FNAB

Fine-needle aspiration biopsy

G

Gauge

MDCT

Multidetector CT

MPR

Multiplanar reconstruction

PNX

Pneumothorax

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Patient consent

Informed consent was obtained from all patients before diagnostic examination.

Financial disclosure

The authors have no financial relationships relevant to this article to disclose.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of Medicine and Health Sciences “V. Tiberio”University of MoliseCampobassoItaly
  2. 2.Medical Oncology UnitUniversity Hospital of ParmaParmaItaly
  3. 3.Department of NeuroscienceUniversity of ParmaParmaItaly
  4. 4.Department of Internal and Experimental Medicine, Magrassi-LanzaraSecond University of NaplesNaplesItaly
  5. 5.Department of RadiologyUniversity of Parma, Parma HospitalParmaItaly

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