Authors (including presenting author) :
Wong HYF(1), Chan E(1), Mui C(1), Cheng WP(1), Wong W(1), Choi KKH(1), Lam HYS(1)
Affiliation :
(1)Department of Radiology, Queen Mary Hospital, Hong Kong
Introduction :
The rising incidence of lung cancer, combined with the increasing need for molecular testing in the age of targeted therapy, has resulted in growing demand for tissue biopsy. While CT has been the most common modality for percutaneous lung biopsy, expanding CT-guided biopsy service is difficult in view of limited scanner availability. Limitations on bronchoscopy during the COVID-19 pandemic have only added to the pressure on our service. In our department, suitable lung lesions are biopsied under sonographic or fluoroscopic guidance, allowing limited radiological resources to be maximized to meet increasing demand. In addition, these modalities offer real time guidance which is advantageous for certain lesions such as those close to the diaphragm. Our hybrid fluoroscopic technique can also utilize cone-beam CT to tackle technically challenging cases.
Objectives :
(1) To evaluate the effectiveness of utilizing non-CT guided lung biopsy in shortening waiting time. (2) To ensure the quality and safety of fluoroscopic-guided lung biopsy are up to international standards.
Methodology :
The waiting times for different image-guided lung biopsies in 2019-20 were assessed. A clinical audit of all patients who underwent fluoroscopic-guided lung biopsy in Queen Mary Hospital in July 2019 – December 2020 was performed to ensure quality and safety.
Result & Outcome :
In 2019-20, the waiting time for non-CT guided lung biopsies was up to 4 times shorter than conventional CT-guided procedures (12 days vs 51 days). There is no compromise in diagnostic quality, achieving 98% in both technical success and sample adequacy, meeting international standards for percutaneous lung biopsy. Complication rates are also within limits. In selected cases, non-CT guided biopsy not only enables earlier diagnosis, but also allows flexible deployment of resources to help ease the pressure off the busy CT.
