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Abstract

Aim

To evaluate (1) the usefulness of thoracic ultrasound in diagnosis and staging of bronchogenic carcinoma by comparing lesion detectability between thoracic- ultrasound and computed tomography and (2) the outcome of thoracic-ultrasound-guided biopsy in diagnosing bronchogenic carcinoma.

Methods

We conducted a cross-sectional study on 53 patients of confirmed bronchogenic carcinoma. All patients had been investigated by thoracic-ultrasound and chest-computed tomography; data regarding the presence of mass (its size, necrosis), lymph nodes invasion, peritumoural atelectasis, consolidations, pleural effusion, chest wall invasion, and paralysis of the diaphragm were recorded. Thoracic-ultrasound-guided biopsy was done for 41 patients.

Results

Thoracic-ultrasound had significantly higher detection rate of peritumoural atelectasis, paralysis of the diaphragm, and supraclavicular lymph nodes invasion, while it has significantly lower detection rate of pulmonary masses and mediastinal lymph nodes invasion than computed tomography. It has nonsignificant higher detection rate of pleural effusion, consolidations, chest wall invasion and necrosis within mass than computed tomography. Thoracic-ultrasound detects static air-bronchogram and/or fluid bronchogram in 53.3% of bronchogenic carcinoma-associated consolidation. Thoracic-ultrasound-guided biopsy revealed positive yield in 78.0% (32/41) of patients. All patients with negative thoracic-ultrasound biopsy had mass size >5 cm with necrosis within the mass. Self-limited complications occurred in 26.8% after thoracic-ultrasound-guided biopsy (haemoptysis 22.0%, pneumothorax 2.4% and subcutaneous emphysema 2.4%).

Conclusion

Thoracic-ultrasound has a significant complementary role to computed tomography in diagnosis and staging of bronchogenic carcinoma. Thoracic-ultrasound-guided biopsy revealed good positive yield (78%), its yield was negatively affected by mass size and necrosis. It is a simple, practical and accurate procedure without significant patients’ risks.

Keywords

Transthoracic ultrasound bronchogenic carcinoma static air-bronchogram fluid bronchogram

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References

Hoque

Hashem

Hasan

et al.

Role of CT scan in the evaluation of lung tumor with cytopathilogical correlation. Faridpur Med Coll J 2014; 9: 37–41.

Rivera

Mehta

Wahidi

. Establishing the diagnosis of lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013; 143: e142S–65S.

Cao

et al.

Sonographically guided transthoracic biopsy of peripheral lung and mediastinal lesions. Role of contrast-enhanced sonography. J Ultrasound Med 2011; 30: 1479–1490.

Hansell

Boiselle

Goldin

et al.

Thoracic imaging. Respirology 2010; 15: 393–400.

Silvestri

Gould

Margolis

et al.

Non-invasive staging of non-small cell lung cancer: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest 2007; 132: 178S–201S.

Sperandeo

Filabozzi

Varriale

et al.

Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases. J Ultrasound 2008; 11: 39–46.

Oliveira

Saraiva

. Comparative study between computed tomography and bronchoscopy in the diagnosis of lung cancer. Radiol Bras 2010; 43: 229–235.

Simeone

Mueller

van Sonnenberg

. The uses of diagnostic ultrasound in the thorax. Clin Chest Med 1984; 5: 281–290.

Sartori

Tombesi

. Emerging roles for transthoracic ultrasonography in pulmonary diseases. World J Radiol 2010; 2: 203–214.

10.

Sconfienza

Mauri

Grossi

et al.

Pleural and peripheral lung lesions: comparison of US- and CT-guided biopsy. Radiology 2013; 266: 930–935.

11.

Nadig

Block

. “Drowned lung” following lobectomy and radiation therapy: a case report. J S C Med Assoc 2003; 99: 26–29.

12.

Koegelenberg

CFN

Diacon

Bolliger

Transthoracic ultrasound of the chest wall, pleura, and the peripheral lung. In: Bollger

Herth

FJF

Mayo

et al. (eds). Progress in Respiratory Research 2009; Vol. 37, Basel: Karger, pp. 22–33..

13.

Lichtenstein

Mezière

. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest 2008; 134: 117–125.

14.

Islam

Tonn

Thoracic ultrasound overview. In: Bolliger

Herth

FJF

Mayo

et al. (eds). Clinical chest ultrasound, Sydney: Karger, 2009, pp. 11–20.

15.

Kim

Hur

Lee

et al.

CT fluoroscopy-guided lung biopsy versus conventional CT-guided lung biopsy: a prospective controlled study to assess radiation doses and diagnostic performance. Eur Radiol 2011; 21: 232–239.

16.

Carrafiello

Laganà

Nosari

et al.

Utility of computed tomography (CT) and of fine needle aspiration biopsy (FNAB) in early diagnosis of fungal pulmonary infections: study of infections from filamentous fungi in haematologically immunodeficient patients. Radiol Med 2006; 111: 33–41.

17.

Muller

. Imaging of the pleura. Radiology 1993; 186: 297–309.

18.

García-Ortega

Briones-Gómez

Fabregat

et al.

Benefit of chest ultrasonography in the diagnosis of peripheral thoracic lesions in an interventional pulmonology unit. Arch Bronconeumol 2016; 52: 244–249.

19.

Chira

Mircea

. Intrathoracic tumors in contact with the chest wall – ultrasonographic and computed tomography comparative evaluation. Med Ultrason 2012; 14: 115–119.

20.

Blank

. Interventional chest sonography. In: Chest sonography, Berlin, Germany: Springer-Verlag Berlin Heidelberg, 2011, pp. 187–209.

21.

Hoosein

Barnes

Khan

et al.

The importance of ultrasound in staging and gaining a pathological diagnosis in patients with lung cancer a two year single centre experience. Thorax 2011; 66: 414–417.

22.

Lichtenstein

Mezie're

Seitz

. The dynamic air bronchogram a lung ultrasound sign of alveolar consolidation ruling out atelectasis. Chest 2009; 135: 1421–1425.

23.

Chian

Soh

. Echogenic swirling pattern as a predictor of malignant pleural effusions in patients with malignancies. Chest 2004; 126: 129e34–129e34.

24.

Doerschug

Schmidt

. Intensive care ultrasound: III. Lung and pleural ultrasound for the intensivist. Ann Am Thorac Soc 2013; 10: 708–712.

25.

Miller

. Practical approach to lung ultrasound. BJA Educ 2016; 16: 39–45.

26.

Rednic

Orăş an

. Subpleural lung tumours ultrasonography. Med Ultrason 2010; 12: 81–87.

27.

Kumaran

Benamore

Vaidhyanath

et al.

Ultrasound guided cytological aspiration of supraclavicular lymph nodes in patients with suspected lung cancer. Thorax 2005; 60: 229–233.

28.

Koegelenberg

Bolliger

Irusen

et al.

The diagnostic yield and safety of ultrasound-assisted biopsy of mediastinal masses. Respiration 2011; 81: 134–141.

29.

Abu-Youssef

Kamel

Selim

et al.

Study of the added value of transthoracic ultrasound in staging of lung cancer. Egypt J Chest Dis Tuberc 2014; 63: 10–25.

30.

Santos-Martínez

Curull

Blanco

et al.

Lung cancer at a university hospital: epidemiological and histological characteristics of a recent and a historical series. Arch Bronconeumol 2005; 41: 307–312.

31.

Rawat

Sindhwani

Gaur

et al.

Clinico-pathological profile of lung cancer in Uttarakhand. Lung India 2009; 26: 74–76.

32.

Saade C and Sydney NSW/AU. Imaging of the Supraclavicular lymph node in routine oncology screening: an MDCT approach. ECR 2012, Poster No.: C-0563.

33.

Overhagen

Brakel

Heijenbrok

et al.

Metastases in supraclavicular lymph nodes in lung cancer: assessment with palpation, US, and CT. Radiology 2004; 232: 75–80.

34.

Fultz

Harrow

Elvey

. Sonographically guided biopsy of supraclavicular lymph nodes: a simple alternative to lung biopsy and other more invasive procedures. AJR 2003; 180: 1403–1409.

35.

Caroli

Dell'Amore

Cassanelli

et al.

Accuracy of transthoracic ultrasound for the prediction of chest wall infiltration by lung cancer and of lung infiltration by chest wall tumours. Heart Lung Circ 2015; 24: 1020–1026.

36.

Bandi

Lunn

Ernst

et al.

Ultrasound vs. CT in detecting chest wall invasion by tumor. A prospective study. Chest 2008; 133: 881–886.

37.

Kurian

Levin

Han

et al.

Comparison of ultrasound and CT in the evaluation of pneumonia complicated by parapneumonic effusion in children. AJR 2009; 193: 1648–1654.

38.

El-Shimya

El-Emery

Abd El-Zaher

et al.

The diagnostic value of ultrasound-guided percutaneous transthoracic core-needle biopsy versus computed tomography-guided biopsy in peripheral intrathoracic lesions. Egypt J Bronchol 2016; 10: 12–19.

39.

Grasso RF, Luppi G, Giurazza F, et al. Lung core biopsy US-guided: approach to characterise subpleural lesions. Available at: www.myESR.org. Poster No.: C-0197. Congress: ECR 2015. 10.1594/ecr2015/C-0197 (accessed 11 December 2016).

40.

Montaudon

Latrabe

Pariente

et al.

Factors influencing accuracy of CT-guided percutaneous biopsies of pulmonary lesions. Eur Radiol 2004; 14: 1234–1240.

41.

Yeow

Tsay

Cheung

. Factors affecting diagnostic accuracy of CT-guided coaxial cutting needle lung biopsy: retrospective analysis of 631 procedures. J Vasc Interv Radiol 2003; 14: 581–588.

42.

Liao

Chen

Chang

et al.

US-guided transthoracic cutting biopsy for peripheral thoracic lesions less than 3 cm in diameter. Radiology 2000; 217: 685–691.

43.

Scisca

Rizzo

Maisano

et al.

The role of ultrasound-guided aspiration biopsy of peripheral pulmonary nodules: our experience. Anticancer Res 2002; 22: 2521–2523.

44.

Wallace

Krishnamurthy

Broemeling

et al.

CT-guided percutaneous fine-needle aspiration biopsy of small (< or =1-cm) lesions. Radiology 2002; 225: 823–828.

The usefulness of thoracic ultrasonography in diagnosis and staging of bronchogenic carcinoma

Abstract

Aim

Methods

Results

Conclusion

Keywords

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References