Accuracy of ultrasound-guided biopsy in comparison to computed tomography guided biopsy in the diagnosis of peripheral lung lesions

Abstract

Background
Although ultrasonography (US) may detect pulmonary pleural-based thoracic masses, it is still rarely used as a diagnostic biopsing tool for peripheral pulmonary lesions, which are found at the subsegmental bronchi and are usually not detected with routine transbronchial biopsy. We aimed to compare computed tomography (CT) guidance with US guidance for peripheral lung and pleural-based biopsies, and to determine which method is more beneficial in terms of safety, efficacy, and selection criteria.


Results
This study included 80 patients whose CT chest revealed peripheral parenchymal lesions and pleural-based lesions. All patients were subjected to laboratory investigations in the form of: complete blood count, prothrombin time, prothrombin concentration, preprocedural imaging, and postprocedural chest radiography. The mean age among the US guidance group was 58.9, which was near to the mean age in the CT guidance group 58.65. 54% of the US guidance group were males and 45% were females, while in CT guidance group, 34% of them were males and 65% were females. Regarding the lesion size (mm) as categorical and numerical variable, in the US guidance group 12 (28.6%) cases, their lesion was more than (50 mm) while in the CT guidance group 14 (36.8%) cases was less than 10 mm as well as the mean values of the lesion size were higher among US guidance group with nonstatistically significant difference as patients are randomly selected.


Conclusion
US-guided biopsy is a safe method that produces good diagnostic yield in peripheral pulmonary and pleural-based lesions. It avoids needless radiation exposure for patients and may also be conducted at the bedside with a lower complication rate.