Related Experiment Video
Updated: Oct 13, 2026
Point-of-Care Lung Ultrasound in Adults: Image Acquisition
Published on: March 3, 2023
Multidimensional institutional learning curve of ultrasound-guided percutaneous transthoracic lung biopsy: a
Xiubin Tang1, Ming Chen1, Chunrong Zhong1
1Department of Ultrasound, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China.
Background:
Ultrasound-guided percutaneous transthoracic lung biopsy (US-PTLB) provides real-time sampling of peripheral or subpleural lesions, but institutional adoption requires coordinated improvements in efficiency, targeting precision, and safety. We evaluated these domains using sequential cumulative sum (CUSUM) analysis.
Methods:
We retrospectively analyzed data from a prospectively maintained institutional registry, supplemented by routine procedural records, for 120 consecutive ultrasound-guided percutaneous transthoracic lung biopsies performed from August 2024 to October 2025. Total procedure time, needle trajectory deviation requiring redirection, and overall complications represented workflow efficiency, targeting precision, and patient-centered safety. Cubic polynomial smoothing identified descriptive candidate transitions, and Chow tests provided supportive within-cohort evidence of structural changes. Adjusted models evaluated associations with case sequence and measured case-mix factors.
Results:
Candidate transition points occurred at Case 40 for procedure time, Case 64 for trajectory deviation, and Case 75 for complications; all corresponding Chow tests yielded P<0.001. Across three descriptively defined phases, median procedure time was 22.2, 18.2, and 19.4 minutes (P<0.001), trajectory deviation decreased from 22.5% to 14.3% and 2.2% (P=0.017), and complications decreased from 30.0% to 20.0% and 6.7% (P=0.020). Case sequence remained associated with shorter procedure time after adjustment [coefficient, -0.037 minutes per case; 95% confidence interval (CI), -0.051 to -0.024; P<0.001].
Conclusions:
Institutional learning was asynchronous across efficiency, targeting precision, and safety. Procedure time alone did not capture procedural maturity. Reductions in trajectory deviation and complications, with sampling quality preserved, support multidimensional registry-based monitoring. These data-derived transitions are institution-specific and require external validation.