Immediate and Follow-up Imaging Findings after Cone-Beam CT-guided Transbronchial Lung Cryobiopsy

Brian P Pogatchnik; Kai E Swenson; Duy Kevin Duong; Brian Shaller; Harmeet Bedi; H Henry Guo

doi:10.1148/ryct.220149

Immediate and Follow-up Imaging Findings after Cone-Beam CT-guided Transbronchial Lung Cryobiopsy

Radiol Cardiothorac Imaging. 2023 Mar 23;5(2):e220149. doi: 10.1148/ryct.220149. eCollection 2023 Apr.

Authors

Brian P Pogatchnik¹, Kai E Swenson¹, Duy Kevin Duong¹, Brian Shaller¹, Harmeet Bedi¹, H Henry Guo¹

Affiliation

¹ Department of Radiology (B.P.P., H.H.G.) and Division of Pulmonology, Allergy, and Critical Care Medicine, Department of Medicine (D.K.D., B.S., H.B.), Stanford University School of Medicine, 300 Pasteur Dr, S072, Stanford, CA 94305; Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.E.S.); and Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA (K.E.S.).

Abstract

Purpose: To evaluate findings after transbronchial lung cryobiopsy (TBLC) using intraprocedural cone-beam CT (CBCT) and follow-up chest CT examinations.

Materials and methods: A single-center, prospective cohort study was performed with 14 participants (mean age, 65 years ± 13 [SD]; eight male participants) undergoing CBCT-guided TBLC between August 2020 and February 2021 who underwent follow-up chest CT imaging. Intraprocedural CBCT and follow-up chest CT images were interpreted for changes compared with baseline CT images. Statistical analyses were performed using independent samples t test and analysis of variance.

Results: A total of 62 biopsies were performed, with 48 in the field of view of CBCT immediately after biopsy. All 48 biopsy sites had evidence of postprocedural hemorrhage, and 17 (35%) had pneumatoceles at the biopsy site. Follow-up CT images showed resolution of these findings. Solid nodules developed at 18 of the 62 (29%) biopsy sites.

Conclusion: Postbiopsy hemorrhage and pneumatoceles on intraprocedural CBCT images (which were clinically occult and resolved spontaneously) and new solid nodules on follow-up chest CT images were commonly observed after TBLC. These findings may help alleviate unnecessary follow-up imaging and tissue sampling.Keywords: Biopsy/Needle Aspiration, CT, Lungs, Lung Biopsy, Interventional Bronchoscopy© RSNA, 2023.

Keywords: Biopsy/Needle Aspiration; CT; Interventional Bronchoscopy; Lung Biopsy; Lungs.