Volume 24, Issue 5 pp. 453-458
Original Article

Safety and diagnostic performance of pulmonologists performing electromagnetic guided percutaneous lung biopsy (SPiNperc)

Christopher Mallow

Christopher Mallow

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

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Hans Lee

Hans Lee

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

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Catherine Oberg

Catherine Oberg

Division of Pulmonary and Critical Care Medicine, Ichan School of Medicine at Mount Sinai, New York, NY, USA

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Jeffrey Thiboutot

Jeffrey Thiboutot

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

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Jason Akulian

Jason Akulian

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA

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Allen C. Burks

Allen C. Burks

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO, USA

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Branden Luna

Branden Luna

Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, SC, USA

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Sadia Benzaquen

Sadia Benzaquen

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA

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Hitesh Batra

Hitesh Batra

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA

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Jose Cardenas-Garcia

Jose Cardenas-Garcia

Division of Pulmonary and Critical Care Medicine, University of Michigan School, Ann Arbor, MI, USA

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Jennifer Toth

Jennifer Toth

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA

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Jay Heidecker

Jay Heidecker

Division of Pulmonary Medicine, Birmingham Pulmonary Group, Birmingham, AL, USA

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Adam Belanger

Adam Belanger

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA

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Jason McClune

Jason McClune

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA

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Umar Osman

Umar Osman

Division of Pulmonary and Critical Care Medicine, Memorial Health System, Marietta, OH, USA

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Venkatesh Lakshminarayanan

Venkatesh Lakshminarayanan

Division of Pulmonary and Critical Care Medicine, Pulmonary and Critical Care of Atlanta, Atlanta, GA, USA

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Nicholas Pastis

Nicholas Pastis

Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, SC, USA

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Gerard Silvestri

Gerard Silvestri

Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, SC, USA

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Alexander Chen

Alexander Chen

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO, USA

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Lonny Yarmus

Corresponding Author

Lonny Yarmus

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

Correspondence: Lonny Yarmus, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, 5th Floor, Baltimore, MD 21287, USA. Email: [email protected]Search for more papers by this author
First published: 24 January 2019
Citations: 18
(Associate Editor: Pyng Lee; Senior Editor: Phan Nguyen)

ABSTRACT

Background and objective

Percutaneous lung biopsy for diagnostic sampling of peripheral lung nodules has been widely performed by interventional radiologists under computed tomography (CT) guidance. New technology allows pulmonologists to perform percutaneous lung biopsies using electromagnetic (EM) guided technology. With the adoption of this new technique, the safety, feasibility and diagnostic yield need to be explored. The goal of this study was to determine the safety, feasibility and diagnostic yield of EM-guided percutaneous lung biopsy performed by pulmonologists.

Methods

We conducted a retrospective, multicentre study of 129 EM-guided percutaneous lung biopsies that occurred between November 2013 and March 2017. The study consisted of seven academic and three community medical centres.

Results

The average age of participants was 65.6 years, BMI was 26.3 and 50.4% were females. The majority of lesions were in the right upper lobe (37.2%) and left upper lobe (31.8%). The mean size of the lesions was 27.31 mm and the average distance from the pleura was 13.2 mm. Practitioners averaged two fine-needle aspirates and five core biopsies per procedure. There were 23 (17.8%) pneumothoraces, of which 16 (12.4%) received small-bore chest tube placement. The diagnostic yield of percutaneous lung biopsy was 73.7%. When EM-guided bronchoscopic sampling was also performed during the same procedural encounter, the overall diagnostic yield increased to 81.1%.

Conclusion

In this large multicentred series, the use of EM guidance for percutaneous lung biopsies was safe and feasible, with acceptable diagnostic yield in the hands of pulmonologists. A prospective multicentre trial to validate these findings is currently underway (NCT03338049).

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