Ultrasound-guided chest biopsies

Area of Science:

• Thoracic interventions
• Medical imaging
• Interventional pulmonology

Background:

• Sonography is limited for central lung nodules due to aeration.
• Computed tomography (CT) or fluoroscopy traditionally guide biopsies.
• This limitation has historically hindered ultrasound (US) adoption for thoracic interventions.

Purpose of the Study:

• To highlight the utility and effectiveness of ultrasound guidance for various thoracic biopsy procedures.
• To demonstrate that US can be a flexible and efficient tool for tissue diagnosis.

Main Methods:

• Review of ultrasound-guided biopsy techniques for peripheral pulmonary nodules, anterior, superior, and posterior mediastinal masses, and supraclavicular nodes.
• Emphasis on probe orientation and anatomical landmark identification for safe and effective access.
• Discussion of specific probe types for challenging locations.

Main Results:

• Ultrasound-guided biopsy of peripheral pulmonary nodules achieves >90% success rates with <5% complication rates.
• Anterior and superior mediastinal masses are often safely accessible with careful identification of critical structures.
• Posterior mediastinal masses can be biopsied when extending into the pleural region; supraclavicular nodes are often the easiest targets.

Conclusions:

• Ultrasound is a versatile and effective tool for guiding biopsies of peripheral pulmonary nodules and accessible mediastinal lesions.
• Careful technique and anatomical knowledge enable safe and successful ultrasound-guided thoracic interventions.
• Evaluating supraclavicular nodes is crucial for diagnosis and can offer a safe biopsy target.