Ultrasound-guided Percutaneous Needle Aspiration by Pulmonologists: A Study of Factors With Impact on Procedural Yield and Complications

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Abstract

Background:

The availability of portable ultrasound (US) guidance has led to usage by subspecialists outside of radiology. Several subspecialties now perform percutaneous fine-needle aspiration (PFNA) for lesions relevant to their expertise. This is a study of US-guided PFNA performed by interventional pulmonologists at a single institution.

Methods:

We retrospectively reviewed serial US-guided PFNAs performed at an institution with the goals of defining yield, factors relating to yield, and complication rates.

Results:

A total of 111 consecutive lesions were evaluated and 109 biopsied during the study period. Diagnosis was established in 81% of cases (90/109), with a total complication rate of 15% but only 1 case of a need for a higher level of care. Factors associated with increased diagnostic yield were suspicion of malignancy, increased size, and pleural adhesions (lack of pleural sliding). The presence of pleural sliding was associated with increased pneumothorax and decreased yield.

Conclusions:

US-guided PFNA is a valuable tool for the interventional pulmonologist. Both size and pleural sliding have an impact on diagnostic yield.

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