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...

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Autores principales:	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
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/dbf6a85c262847869cbe367aec3ab1e2
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spelling	oai:doaj.org-article:dbf6a85c262847869cbe367aec3ab1e22021-11-28T04:36:10ZSafety and Efficacy of Percutaneous Image-Guided Mediastinal Mass Core-Needle Biopsy2542-454810.1016/j.mayocpiqo.2021.09.006https://doaj.org/article/dbf6a85c262847869cbe367aec3ab1e22021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2542454821001405https://doaj.org/toc/2542-4548Objective: 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.Patrick J. Navin, MB, BCh, BAONathan L. Eickstaedt, MDThomas D. Atwell, MDJason R. Young, MDPatrick W. Eiken, MDBrian T. Welch, MDJohn J. Schmitz, MDGrant D. Schmit, MDMatthew P. Johnson, MSMichael R. Moynagh, MB, BChElsevierarticleMedicine (General)R5-920ENMayo Clinic Proceedings: Innovations, Quality & Outcomes, Vol 5, Iss 6, Pp 1100-1108 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 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
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.
format	article
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
title	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_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_sort	safety and efficacy of percutaneous image-guided mediastinal mass core-needle biopsy
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/dbf6a85c262847869cbe367aec3ab1e2
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Safety and Efficacy of Percutaneous Image-Guided Mediastinal Mass Core-Needle Biopsy

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