Factors Influencing Diagnostic Success of Computed Tomography-guided Transthoracic Needle Biopsy in Intrathoracic Lesions: An Experience of a Reference Chest Disease Hospital

Introduction:Transthoracic needle biopsy (TNB) is a common, safe and inexpensive procedure used in the diagnosis of intrathoracic lesions. Until today, there is still no study about the influence of standardized uptake value (SUVmax) in positron emission tomography/computed tomography (PET/CT) on the diagnostic success of TNB in intrathoracic lesions. We aimed to analyze the factors, one of which was the SUVmax value influencing the diagnosis success of CT-guided TNB in pulmonary, mediastinal and pleural lesions. Secondary aim was to investigate the predictive clinical factors of complications.Methods:A retrospective study of 403 patients who underwent CT-guided TNB at a reference chest diseases hospital between February 2019 and February 2021 was conducted. A pulmonologist had performed the procedure with a 20-gauge fine-needle (Spinal) or a 14-gauge automated needle (tru-cut). Data of pathology, microbiology and clinical follow-up of the patients were collected. A chi-square and Student’s t-test were used to evaluate the patient-related factors (gender and smoking), lesion-related factors (type, side, location, size, presence of necrosis observed by CT, SUVmax value in PET/CT), and procedure factor (type of needle) on the diagnostic success. Additionally, associations between clinical characteristics of patients and the complications were assessed.Results:A total of 403 patients underwent CT-guided TNB were enrolled and overall success was 70% (284/403). Smoking history (75% vs 43%, p=0.02) was predictor for diagnostic success. Lesion size and SUVmax value were significantly high in diagnosed patients (for both p<0.001). Diagnostic success was high in peripheral and central lesions, more notably in central lesions (p=0.004, p=0.016, respectively). The 9.2 SUVmax cut-off value had sensitivity of 79%, specificity of %53, success of 79% (p<0.01). Cardiovascular diseases, anti-coagulants, vitamin K antagonists, and salicylate induced complications (p=0.031, p=0.022, p=0.011, p=0.04, respectively). Low-molecular-weight-heparin was associated with hemorrhage (p=0.016).Conclusion:We observed that type, size and SUVmax value of lesion and smoking status were the predictive factors for a diagnostic biopsy

Relationship between Sarcopenia and Respiratory Functions in Geriatric Male COPD Patients

Introduction: Sarcopenia can be defined as the loss of skeletal muscle mass and strength, especially with aging. In total, 21.6% of patients with chronic obstructive pulmonary disease (COPD) have sarcopenia. In our study, we investigated whether the evaluation of respiratory muscles can be correlated with peripheral muscle measurement and what kind of relationship is between sarcopenia and pulmonary function tests. Methods: A retrospective observational study conducted in a single center included 75 male COPD patients admitted to the pulmonary rehabilitation unit. The data were obtained from the hospital information management system and patient files. Results: The mean age of 75 male patients included in the study was 65±9 years, 76% had a history of smoking, and 46% had comorbidities. Sarcopenia was detected in 20 patients, 16 of whom were over 65 years of age. While the mean Handgrip was 50, Quadriceps 36, and Pinchmeter 17 in all age groups, it was 58, 38, and 17 in the over 65 age group, and 21, 21, and 12 in the 65 age group with cachexia, respectively. There was no statistical relationship between sarcopenia and forced expiratory volume 1 (FEV1), forced vital capacity, FEV1/FEV, Global Initiative for Chronic Obstructive Lung Disease stages, modified Medical Research Council, and COPD assessment test scores in patients over 65 years of age (p>0.05). Conclusion: Although it was observed that the frequency of malnutrition and sarcopenia was higher than normal in the COPD patient group over 65 years of age, a decrease in pulmonary function tests and a decrease in effort capacity due to sarcopenia were observed, a statistically significant result was reached due to the insufficient number of cases