Lung Biopsy: Special Techniques

Transthoracic needle biopsy of the indeterminate pulmonary nodule is a well-established, highly accurate, and minimally invasive diagnostic procedure. A pulmonary nodule in virtually any location is accessible to transthoracic needle biopsy. A solid understanding of special biopsy techniques enables the operator to overcome the commonly encountered challenges, including small, mobile, and partly obscured nodules. Because biopsy-related complications can be reduced but not completely eliminated, a familiarity with such complications and the procedures used to manage them is essential. A close partnership with the cytology team is crucial in achieving a high diagnostic accuracy during transthoracic needle biopsy. In the future, biopsy-derived microarray analysis may play a greater role in guiding treatment and predicting treatment outcomes.

[1]  Patricia L. Harris,et al.  Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib. , 2004, The New England journal of medicine.

[2]  C I Henschke,et al.  Pitfalls in CT-guided transthoracic needle biopsy of pulmonary nodules. , 1996, Radiographics : a review publication of the Radiological Society of North America, Inc.

[3]  F. Hirsch,et al.  Increased epidermal growth factor receptor gene copy number detected by fluorescence in situ hybridization associates with increased sensitivity to gefitinib in patients with bronchioloalveolar carcinoma subtypes: a Southwest Oncology Group Study. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[4]  R. Poe,et al.  Predicting risk of pneumothorax in needle biopsy of the lung. , 1984, Chest.

[5]  T. McLoud,et al.  Effect of patient positioning after needle aspiration lung biopsy. , 1991, Radiology.

[6]  K. Tanisaro.  Patient positioning after fine needle lung biopsy-effect on pneumothorax rate. , 2003, Acta radiologica.

[7]  J. Greif,et al.  Transthoracic needle biopsy of lung masses: a survey of techniques. , 2005, Clinical radiology.

[8]  Y. Nakanishi,et al.  Association of genetic polymorphisms in the base excision repair pathway with lung cancer risk: a meta-analysis. , 2006, Lung cancer.

[9]  K. Murata,et al.  CT-guided needle biopsy of lung lesions: a survey of severe complication based on 9783 biopsies in Japan. , 2006, European journal of radiology.

[10]  P. Tsay,et al.  Factors affecting diagnostic accuracy of CT-guided coaxial cutting needle lung biopsy: retrospective analysis of 631 procedures. , 2003, Journal of vascular and interventional radiology : JVIR.

[11]  E. Sim,et al.  Feasibility of using low-volume tissue samples for gene expression profiling of advanced non-small cell lung cancers. , 2003, Clinical cancer research : an official journal of the American Association for Cancer Research.

[12]  T. Amagasa,et al.  Fluorescence in situ hybridization for detecting genomic alterations of cyclin D1 and p16 in oral squamous cell carcinomas , 2007, Cancer.

[13]  C. Chartrand-Lefebvre,et al.  Lack of effect of position restriction after transthoracic biopsy. , 2001, Radiology.

[14]  R. Lange,et al.  Pneumothorax and dependent versus nondependent patient position after needle biopsy of the lung. , 1999, Radiology.

[15]  T. Nishimura,et al.  Usefulness and Limitation of Manual Aspiration Immediately After Pneumothorax Complicating Interventional Radiological Procedures with the Transthoracic Approach , 2006, CardioVascular and Interventional Radiology.

[16]  D. Schrump,et al.  Lung cancer staging in the genomics era. , 2006, Thoracic surgery clinics.

[17]  M. Meyerson,et al.  Molecular classification and molecular genetics of human lung cancers. , 2004, Seminars in oncology.

[18]  O. Miettinen,et al.  Survival of Patients with Stage I Lung Cancer Detected on CT Screening , 2008 .

[19]  J. Ramírez,et al.  Autologous blood clot seal to prevent pneumothorax at CT-guided lung biopsy. , 2000, Radiology.

[20]  R B Altman,et al.  The Pharmacogenetics Research Network: From SNP Discovery to Clinical Drug Response , 2007, Clinical pharmacology and therapeutics.

[21]  T. McLoud,et al.  Diagnostic accuracy and safety of CT-guided percutaneous needle aspiration biopsy of the lung: comparison of small and large pulmonary nodules. , 1996, AJR. American journal of roentgenology.

[22]  E. Akkaya,et al.  Computed tomography‐guided transthoracic fine‐needle aspiration in diagnosis of lung cancer: A comparison of single‐pass needle and multiple‐pass coaxial needle systems and the value of immediate cytological assessment , 2004, Respirology.

[23]  C I Henschke,et al.  Needle‐Tip Repositioning During Computed‐Tomography—Guided Transthoracic Needle Aspiration Biopsy of Small Deep Pulmonary Lesions: Minor Adjustments Make a Big Difference , 1996, Journal of thoracic imaging.

[24]  J. Cigudosa,et al.  Expression signatures in lung cancer reveal a profile for EGFR‐mutant tumours and identify selective PIK3CA overexpression by gene amplification , 2008, The Journal of pathology.

[25]  J. Austin,et al.  Value of having a cytopathologist present during percutaneous fine-needle aspiration biopsy of lung: report of 55 cancer patients and metaanalysis of the literature. , 1993, AJR. American journal of roentgenology.

[26]  K. Miller,et al.  Postbiopsy pneumothorax: estimating the risk by chest radiography and pulmonary function tests. , 1988, AJR. American journal of roentgenology.

[27]  V Latrabe,et al.  Pneumothoraces and chest tube placement after CT-guided transthoracic lung biopsy using a coaxial technique: incidence and risk factors. , 1999, AJR. American journal of roentgenology.

[28]  Patient positioning after lung biopsy: influence on the incidence of pneumothorax. , 2003, Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes.

[29]  E. Moore,et al.  Technical aspects of needle aspiration lung biopsy: a personal perspective. , 1998, Radiology.

[30]  D. Carbone,et al.  Proteomics analysis in lung cancer: Challenges and opportunities , 2007, Respirology.

[31]  C I Henschke,et al.  Percutaneous CT biopsy of chest lesions: an in vitro analysis of the effect of partial volume averaging on needle positioning. , 1993, AJR. American journal of roentgenology.

[32]  C I Henschke,et al.  CT-guided transthoracic needle biopsy of small solitary pulmonary nodules. , 1997, Clinical imaging.

[33]  Lakshmanan K. Iyer,et al.  A combined approach to data mining of textual and structured data to identify cancer-related targets , 2006, BMC Bioinformatics.

[34]  C. Henschke,et al.  Angulated needle placement in CT-guided percutaneous needle biopsy of the thorax. , 1993, Clinical imaging.

[35]  T. Nishimura,et al.  Management of pneumothorax after percutaneous CT-guided lung biopsy. , 2002, Chest.

[36]  Michael Ruogu Zhang,et al.  Molecular characteristics of non-small cell lung cancer , 2001, Proceedings of the National Academy of Sciences of the United States of America.

[37]  F. Martinez,et al.  Risk of pneumothorax in CT-guided transthoracic needle aspiration biopsy of the lung. , 1996, Radiology.

[38]  D. Arango,et al.  Microarray analysis in the clinical management of cancer. , 2003, Hematology/oncology clinics of North America.

[39]  T. McLoud,et al.  Factors influencing pneumothorax rate at lung biopsy: are dwell time and angle of pleural puncture contributing factors? , 2001, Radiology.

[40]  Y. Gong,et al.  [Value of diagnosing micrometastasis by nested RT-PCR in the peripheral blood and bone marrow in non-small cell lung cancer patients]. , 2003, Zhonghua zhong liu za zhi [Chinese journal of oncology].

[41]  A. James,et al.  Single-nucleotide polymorphisms and lung disease: clinical implications. , 2007, Chest.

[42]  A. Iafrate,et al.  Validation of chromogenic in situ hybridization for detection of EGFR copy number amplification in nonsmall cell lung carcinoma , 2007, Modern Pathology.

[43]  K. Tsuneyama,et al.  High-density oligonucleotide microarrays and functional network analysis reveal extended lung carcinogenesis pathway maps and multiple interacting genes in NNK [4-(methylnitrosamino)-1-(3-pyridyle)-1-butanone] induced CD1 mouse lung tumor , 2006, Journal of Cancer Research and Clinical Oncology.

[44]  F. García-Río,et al.  Use of spirometry to predict risk of pneumothorax in CT-guided needle biopsy of the lung. , 1996, Journal of computer assisted tomography.

[45]  Shi Minghong,et al.  Transthoracic Needle Aspiration Biopsy:Variables That Affect Risk of Pneumothorax , 2009 .

[46]  T. McLoud,et al.  Positional precautions in needle aspiration lung biopsy. , 1990, Radiology.

[47]  W. Cai,et al.  High resolution analysis of genomic aberrations by metaphase and array comparative genomic hybridization identifies candidate tumour genes in lung cancer cell lines. , 2007, Cancer letters.

[48]  F. Gleeson,et al.  Guidelines for radiologically guided lung biopsy , 2003, Thorax.

[49]  J. Quinn,et al.  Detection of small cell lung cancer by RT-PCR for neuropeptides, neuropeptide receptors, or a splice variant of the neuron restrictive silencer factor. , 2003, Methods in molecular medicine.

[50]  J C Eggleston,et al.  Transthoracic needle aspiration biopsy of benign and malignant lung lesions. , 1985, AJR. American journal of roentgenology.

[51]  M. Nasiell,et al.  Cytologic differential diagnosis of bronchiolo-alveolar carcinoma and bronchogenic adenocarcinoma. , 1976, Acta cytologica.

[52]  H. Mehdorn,et al.  p53, BCL-2 and BAX in non-small cell lung cancer brain metastases: a comparison of real-time RT-PCR, ELISA and immunohistochemical techniques , 2007, Neurological research.

[53]  Daniel Y Sze,et al.  CT-guided transthoracic needle aspiration biopsy of pulmonary nodules: needle size and pneumothorax rate. , 2003, Radiology.

[54]  The radiologic appearance of solitary pulmonary nodules and their cytologic-histologic correlation. , 2000, Seminars in ultrasound, CT, and MR.

[55]  T. Shibata,et al.  Epidermal growth factor receptor gene mutations and increased copy numbers predict gefitinib sensitivity in patients with recurrent non-small-cell lung cancer. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[56]  Yun-Chung Cheung,et al.  Risk factors of pneumothorax and bleeding: multivariate analysis of 660 CT-guided coaxial cutting needle lung biopsies. , 2004, Chest.

[57]  A. Sapino,et al.  Predicting gefitinib responsiveness in lung cancer by fluorescence in situ hybridization/chromogenic in situ hybridization analysis of EGFR and HER2 in biopsy and cytology specimens , 2007, Molecular Cancer Therapeutics.

[58]  L. Santambrogio,et al.  CT-guided fine-needle aspiration cytology of solitary pulmonary nodules: a prospective, randomized study of immediate cytologic evaluation. , 1997, Chest.

[59]  Anatoly L. Mayburd,et al.  Ingenuity Network-Assisted Transcription Profiling: Identification of a New Pharmacologic Mechanism for MK886 , 2006, Clinical Cancer Research.

[60]  C. Henschke,et al.  Aspiration of a large pneumothorax resulting from transthoracic needle biopsy. , 1996, Radiology.