Source: Annual Congress 2002 - Thoracic ultrasound and photodynamic therapy
Disease area: Thoracic oncology

Abstract

Background
Tumors involving or abutting the pleura are usually visible with transthoracic ultrasound (US). US-assisted biopsy techniques offer an inexpensive alternative to CT-guidance or thoracoscopy in selected cases, but yield and safety are unknown.
Method
In a bronchoscopy theatre, suitable tumors were located with ultrasound on site and biopsied under local anaesthesia. A 14G Tru-Cut needle was employed with the [dsquote]free-hand[dsquote] technique (no dedicated biopsy sonar probe). As from the introduction of the method, all procedures were prospectively recorded.
Results
Within 18 months, 62 patients underwent 66 biopsies for peripheral lung tumors (52%), pleural based (35%), mediastinal (8%), or chest wall lesions (6%). Overall yield was 89% (malignant: 76%; benign: 13%). Biopsies were false negative in 6%, and technically insufficient in 5%. Eight mesotheliomas accounted for 17% of the malignancies with a yield of 100%. Adverse effects occurred in 8 patients (pneumothorax: 4, 2 drained; superficial bleeding, mild haemoptysis, and syncope: 1).
Conclusion
For the assessment of chest lesions involving the pleura, US-assisted Tru-Cut biopsy is accurate, simple, safe and well tolerated. Mesothelioma can reliably be diagnosed on the material harvested.

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Citations should be made in the following way:
A. H. Diacon, M. M. Schuurmans, M. Louw, C. A. Wright, C. T. Bolliger (Cape Town, South Africa). Ultrasound assisted Tru-Cut biopsy of pleural tumors: a prospective analysis of 62 consecutive cases in a high incidence area for malignant mesothelioma. Eur Respir J 2002; 20: Suppl. 38, 3716

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