Contrast-enhanced Imaging in Peripheral Pulmonary Lesions: The Role in US-guided Biopsies.

IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Radiology. Cardiothoracic imaging Pub Date : 2024-06-01 DOI:10.1148/ryct.230234
Xue-Yan Wang, Zhi-Fan Yuan, Ke-Hong Gan, Yuan Zhong, Jia-Xin Huang, Wei-Jun Huang, Yu-Huan Xie, Xiao-Qing Pei
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Abstract

Purpose To compare the tissue adequacy and diagnostic accuracy of US-guided biopsies of peripheral pulmonary lesions (PPLs) with and without contrast agents. Materials and Methods A retrospective study was conducted at four medical centers in patients with PPLs who underwent US-guided percutaneous transthoracic needle biopsy (PTNB) between January 2017 and October 2022. The patients were divided into contrast-enhanced US (CEUS) and US groups based on whether prebiopsy CEUS evaluation was performed. Tissue adequacy and the diagnostic accuracy of PTNB, stratified by lesion size, were analyzed and compared between groups. A propensity score matching (PSM) analysis was conducted using the nearest-neighbor matching method. Results A total of 1027 lesions were analyzed, with 634 patients (mean age, 59.4 years ± 13.0 [SD]; 413 male) in the US group and 393 patients (mean age, 61.2 years ± 12.5; 270 male) in the CEUS group. The CEUS group produced more acceptable samples than the US group (98.2% vs 95.7%; P = .03) and achieved higher diagnostic accuracy (96.9% vs 94.2%; P = .04), with no evidence of a difference in sensitivity (96.7% vs 94.0%; P = .06). PSM and stratified analyses (n = 358 per group) indicated higher tissue adequacy (99.0% vs 95.7%; P = .04) and diagnostic accuracy (98.5% vs 92.9%; P = .006) in the CEUS group compared with the US group for 2-7-cm PPLs but not for lesions larger than 7 cm. Conclusion PTNB with prebiopsy CEUS evaluation demonstrated significantly better tissue adequacy and diagnostic accuracy compared with US guidance alone for PPLs ranging from 2 to 7 cm, with similar biopsy performance achieved between groups for lesions larger than 7 cm. Keywords: Contrast Material, Thoracic Diseases, Ultrasonography, Image-Guided Biopsy © RSNA, 2024.

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外周肺部病变的对比增强成像:在 US 引导活检中的作用。
目的 比较使用和不使用造影剂进行 US 引导下肺外周病变 (PPL) 活检的组织充分性和诊断准确性。材料与方法 在四个医疗中心对 2017 年 1 月至 2022 年 10 月期间接受 US 引导下经皮经胸穿刺活检(PTNB)的 PPL 患者进行了回顾性研究。根据是否进行活检前CEUS评估,将患者分为对比增强US(CEUS)组和US组。根据病变大小进行分层,分析并比较各组间的组织充分性和PTNB的诊断准确性。采用最近邻匹配法进行倾向得分匹配(PSM)分析。结果 共分析了 1027 个病灶,其中 US 组有 634 名患者(平均年龄为 59.4 岁 ± 13.0 [SD];413 名男性),CEUS 组有 393 名患者(平均年龄为 61.2 岁 ± 12.5;270 名男性)。CEUS 组比 US 组产生了更多可接受的样本(98.2% vs 95.7%;P = .03),并获得了更高的诊断准确性(96.9% vs 94.2%;P = .04),但没有证据表明灵敏度存在差异(96.7% vs 94.0%;P = .06)。PSM 和分层分析(每组 n = 358)表明,与 US 组相比,CEUS 组对 2-7 厘米 PPL 的组织充分性(99.0% vs 95.7%;P = .04)和诊断准确性(98.5% vs 92.9%;P = .006)更高,但对大于 7 厘米的病变则没有差异。结论 对于 2-7 厘米的 PPL,CEUS 评估活检前 PTNB 的组织充分性和诊断准确性明显优于单纯 US 引导,而对于大于 7 厘米的病变,两组的活检效果相似。关键词造影剂、胸腔疾病、超声、图像引导活检 © RSNA, 2024.
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