Journal article
Percutaneous Lung Biopsy in Immunocompromised Pediatric Patients
Journal of vascular and interventional radiology, v 31(1), pp 93-98
01 Jan 2020
PMID: 31767410
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose: To determine the diagnostic yield and safety of image-guided lung biopsies in immunocompromised pediatric patients.
Materials and Methods: This was a retrospective pediatric cohort study conducted from June 2000 to April 2017. Subjects were 0-17 years of age (median, 10 years of age). There were 46 males (48%). A total of 73 consecutive image-guided lung biopsies were performed in 68 patients (weight range, 4.9-97.3 kg [median, 25.3 kg]). The indication for biopsy was to isolate an organism to tailor medical therapy. All patients were immunocompromised with an underlying history of bone marrow transplantation (n = 50), primary immunodeficiency (n = 14) and solid organ transplantation (n = 4). Patient and technical factors were analyzed for rates of complication.
Results: Overall diagnostic yield was 43 of 73 patients (60%). There were 14 minor (19%) and 8 major (11%) complications. Major complications included pneumothorax or hemoptysis requiring intervention (n = 6), and death (n = 2). The histological diagnosis was an infectious;cause in 5 of 8 major complications (63%). There were statistically significant differences between the rates of complications with the imaging modality used (P = -.02) and the use of fine needle, aspiration (P = .02).
Conclusions: Image-guided percutaneous lung biopsy can be helpful in isolating an organism to tailor therapy. Biopsies performed in immunosuppressed patients result in an elevated complication risk of up to 30% and demonstrate lower diagnostic yield and increased mortality, which should warrant detailed discussion with the primary team and family.
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Details
- Title
- Percutaneous Lung Biopsy in Immunocompromised Pediatric Patients
- Creators
- Heather Cleveland - Texas Children's HospitalAlex Chau - Texas Children's HospitalZachary Jeng - Baylor College of MedicineGregory Gardner - Texas Children's HospitalRaphael Yoo - Texas Children's HospitalWei Zhang - Texas Children's HospitalJose Hernandez - Texas Childrens Hosp, Dept Intervent Radiol, 6621 Fannin St, Houston, TX 77030 USA
- Publication Details
- Journal of vascular and interventional radiology, v 31(1), pp 93-98
- Publisher
- Elsevier
- Number of pages
- 6
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000507428900014
- Scopus ID
- 2-s2.0-85076520876
- Other Identifier
- 991021862414104721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Peripheral Vascular Disease
- Radiology, Nuclear Medicine & Medical Imaging