Diagnostic accuracy and complication rates of percutaneous CT-guided coaxial needle biopsy of pulmonary lesions

PURPOSEThe aim of this retrospective study was to evaluate and compare diagnostic accuracy and complication rates of percutaneous computed tomography (CT)-guided biopsies of pulmonary lesions 10–35 mm, 35–50 mm, and >50 mm, using the coaxial biopsy technique.METHODSOver a 4-year period, 235 lung biopsies were performed using the coaxial biopsy technique with 18G semi-automated true-cut needle. There were 163 (69.4%) male and 72 (30.6%) female patients, with a mean age of 64.01±9.18 years (18–85 years). The mean lesion size was 59.6±29.3 mm. The lesions were stratified into three groups according to size: lesions 50 mm (n=140, 59.6%). Diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for all biopsies, and for each group separately, as well as the incidence of complications.RESULTSThe overall diagnostic accuracy was 95.4%, with 95.52% sensitivity, 100% specificity, 100% PPV, and 47.37% NPV. For lesions 50 mm, with 93.65% sensitivity, 100% specificity, 100% PPV, and 42.86% NPV. An adequate sample was obtained in 219 core biopsies (93.2%), while 16 biopsies (6.8%) were nondiagnostic due to necrosis (4.25%) and insufficient biopsy material (2.55%). The most frequent complication was minor pneumothorax, which was seen at a rate of 19.1%; pneumothorax requiring chest tube placement occurred in 3 patients (1.3%).CONCLUSIONDiagnostic accuracy decreased with increasing lesion size. On the other hand, complication rates were higher in smaller lesions, more distanced from the pleura

Successful minimally invasive management of nonvascular grade IV blunt renal trauma with complete transection in a 7-year-old girl

Non-operative treatment of high-grade renal trauma in hemodynamically stable children is gaining increasing acceptance nowadays. However, the management of isolated grade IV injuries, particularly those with complete renal fracture and separation of the poles with intact blood supply, is still controversial. Although such injuries have a decreased likelihood of spontaneous resolution, not all require open operative repair. They can be treated with a minimally invasive combination of internal and external drainage. Herein, we report a case of a 7-year-old girl who presented with a nonvascular grade IV blunt renal trauma with a complete renal transection, successfully treated with ureteral stent placement and ultrasound-guided percutaneous drainage of the perinephric urinoma. We also present a brief literature review on this rare lesion in children.The article-processing fee was covered by the Qatar National Library (QNL)