Safety and Efficacy of Percutaneous Image-Guided Mediastinal Mass Core-Needle Biopsy
Objective: To retrospectively evaluate the safety and efficacy of percutaneous image-guided mediastinal mass core-needle biopsy. Patients and Methods: Retrospective review of an institutionally maintained biopsy registry identified 337 computed tomography– or ultrasound-guided percutaneous mediastin...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-12-01
|
| Series: | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2542454821001405 |
| _version_ | 1798026812493660160 |
|---|---|
| author | Patrick J. Navin, MB, BCh, BAO Nathan L. Eickstaedt, MD Thomas D. Atwell, MD Jason R. Young, MD Patrick W. Eiken, MD Brian T. Welch, MD John J. Schmitz, MD Grant D. Schmit, MD Matthew P. Johnson, MS Michael R. Moynagh, MB, BCh |
| author_facet | Patrick J. Navin, MB, BCh, BAO Nathan L. Eickstaedt, MD Thomas D. Atwell, MD Jason R. Young, MD Patrick W. Eiken, MD Brian T. Welch, MD John J. Schmitz, MD Grant D. Schmit, MD Matthew P. Johnson, MS Michael R. Moynagh, MB, BCh |
| author_sort | Patrick J. Navin, MB, BCh, BAO |
| collection | DOAJ |
| description | Objective: To retrospectively evaluate the safety and efficacy of percutaneous image-guided mediastinal mass core-needle biopsy. Patients and Methods: Retrospective review of an institutionally maintained biopsy registry identified 337 computed tomography– or ultrasound-guided percutaneous mediastinal mass core needle biopsies between October 2002 and August 2017 in a single quaternary referral center. Mean patient age was 51 (range, 18 to 93) years. Procedural techniques, anticoagulation/antiplatelet therapy, and tumor anatomical characteristics were reviewed. Classification and gradation of complications was based on the Clavien-Dindo system. Diagnostic yield was defined as the ratio of diagnostic biopsy to all biopsies performed. Results: Mean tumor size was 59.2 (range, 10 to 180) mm with 89.9% (n=303) of lesions located in the prevascular (anterior) mediastinum. There was a single major complication (0.3%) of a symptomatic pneumothorax requiring intervention. There were seven (2.1%) minor complications, including three bleeding complications. A transpleural approach was the only variable associated with an increased complication rate (P<.01). Forty-one (12.2%) patients had a biopsy performed while taking an antiplatelet/anticoagulant agent within the therapeutic window, with a single case (0.3%) associated with a minor bleeding complication. Of 18 (5.3%) procedures performed without cessation of anticoagulant/antiplatelet therapy, there were no bleeding complications. Of all 337 biopsies, 322 (95.5%) were diagnostic. None of the analyzed variables were significantly associated with a nondiagnostic biopsy. Conclusion: Image-guided percutaneous core-needle biopsy of mediastinal masses is a safe procedure with high diagnostic yield. Further prospective studies are required to assess the complication profile in higher risk patients. |
| first_indexed | 2024-04-11T18:41:16Z |
| format | Article |
| id | doaj.art-dbf6a85c262847869cbe367aec3ab1e2 |
| institution | Directory Open Access Journal |
| issn | 2542-4548 |
| language | English |
| last_indexed | 2024-04-11T18:41:16Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| spelling | doaj.art-dbf6a85c262847869cbe367aec3ab1e22022-12-22T04:08:59ZengElsevierMayo Clinic Proceedings: Innovations, Quality & Outcomes2542-45482021-12-015611001108Safety and Efficacy of Percutaneous Image-Guided Mediastinal Mass Core-Needle BiopsyPatrick J. Navin, MB, BCh, BAO0Nathan L. Eickstaedt, MD1Thomas D. Atwell, MD2Jason R. Young, MD3Patrick W. Eiken, MD4Brian T. Welch, MD5John J. Schmitz, MD6Grant D. Schmit, MD7Matthew P. Johnson, MS8Michael R. Moynagh, MB, BCh9Department of Radiology, Mayo Clinic, Rochester, MN; Correspondence: Address to Patrick J. Navin, MB, BCh, BAO, Department of Radiology, Mayo Clinic, 200 First Street, NW, Rochester, MN 55901.Department of Radiology, Mayo Clinic, Rochester, MNDepartment of Radiology, Mayo Clinic, Rochester, MNDepartment of Radiology, Mayo Clinic, Rochester, MNDepartment of Radiology, Mayo Clinic, Rochester, MNDepartment of Radiology, Mayo Clinic, Rochester, MNDepartment of Radiology, Mayo Clinic, Rochester, MNDepartment of Radiology, Mayo Clinic, Rochester, MNDepartment of Health Sciences Research, Mayo Clinic, Rochester, MNDepartment of Radiology, Mayo Clinic, Rochester, MNObjective: To retrospectively evaluate the safety and efficacy of percutaneous image-guided mediastinal mass core-needle biopsy. Patients and Methods: Retrospective review of an institutionally maintained biopsy registry identified 337 computed tomography– or ultrasound-guided percutaneous mediastinal mass core needle biopsies between October 2002 and August 2017 in a single quaternary referral center. Mean patient age was 51 (range, 18 to 93) years. Procedural techniques, anticoagulation/antiplatelet therapy, and tumor anatomical characteristics were reviewed. Classification and gradation of complications was based on the Clavien-Dindo system. Diagnostic yield was defined as the ratio of diagnostic biopsy to all biopsies performed. Results: Mean tumor size was 59.2 (range, 10 to 180) mm with 89.9% (n=303) of lesions located in the prevascular (anterior) mediastinum. There was a single major complication (0.3%) of a symptomatic pneumothorax requiring intervention. There were seven (2.1%) minor complications, including three bleeding complications. A transpleural approach was the only variable associated with an increased complication rate (P<.01). Forty-one (12.2%) patients had a biopsy performed while taking an antiplatelet/anticoagulant agent within the therapeutic window, with a single case (0.3%) associated with a minor bleeding complication. Of 18 (5.3%) procedures performed without cessation of anticoagulant/antiplatelet therapy, there were no bleeding complications. Of all 337 biopsies, 322 (95.5%) were diagnostic. None of the analyzed variables were significantly associated with a nondiagnostic biopsy. Conclusion: Image-guided percutaneous core-needle biopsy of mediastinal masses is a safe procedure with high diagnostic yield. Further prospective studies are required to assess the complication profile in higher risk patients.http://www.sciencedirect.com/science/article/pii/S2542454821001405 |
| spellingShingle | Patrick J. Navin, MB, BCh, BAO Nathan L. Eickstaedt, MD Thomas D. Atwell, MD Jason R. Young, MD Patrick W. Eiken, MD Brian T. Welch, MD John J. Schmitz, MD Grant D. Schmit, MD Matthew P. Johnson, MS Michael R. Moynagh, MB, BCh Safety and Efficacy of Percutaneous Image-Guided Mediastinal Mass Core-Needle Biopsy Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| title | Safety and Efficacy of Percutaneous Image-Guided Mediastinal Mass Core-Needle Biopsy |
| title_full | Safety and Efficacy of Percutaneous Image-Guided Mediastinal Mass Core-Needle Biopsy |
| title_fullStr | Safety and Efficacy of Percutaneous Image-Guided Mediastinal Mass Core-Needle Biopsy |
| title_full_unstemmed | Safety and Efficacy of Percutaneous Image-Guided Mediastinal Mass Core-Needle Biopsy |
| title_short | Safety and Efficacy of Percutaneous Image-Guided Mediastinal Mass Core-Needle Biopsy |
| title_sort | safety and efficacy of percutaneous image guided mediastinal mass core needle biopsy |
| url | http://www.sciencedirect.com/science/article/pii/S2542454821001405 |
| work_keys_str_mv | AT patrickjnavinmbbchbao safetyandefficacyofpercutaneousimageguidedmediastinalmasscoreneedlebiopsy AT nathanleickstaedtmd safetyandefficacyofpercutaneousimageguidedmediastinalmasscoreneedlebiopsy AT thomasdatwellmd safetyandefficacyofpercutaneousimageguidedmediastinalmasscoreneedlebiopsy AT jasonryoungmd safetyandefficacyofpercutaneousimageguidedmediastinalmasscoreneedlebiopsy AT patrickweikenmd safetyandefficacyofpercutaneousimageguidedmediastinalmasscoreneedlebiopsy AT briantwelchmd safetyandefficacyofpercutaneousimageguidedmediastinalmasscoreneedlebiopsy AT johnjschmitzmd safetyandefficacyofpercutaneousimageguidedmediastinalmasscoreneedlebiopsy AT grantdschmitmd safetyandefficacyofpercutaneousimageguidedmediastinalmasscoreneedlebiopsy AT matthewpjohnsonms safetyandefficacyofpercutaneousimageguidedmediastinalmasscoreneedlebiopsy AT michaelrmoynaghmbbch safetyandefficacyofpercutaneousimageguidedmediastinalmasscoreneedlebiopsy |