Background: The diagnostic yield (DY) and safety of computed tomography(CT)-guided and thoracic ultrasound(TUS)-guided biopsy of pleural lesions have been investigated in a number of studies, but no synthesis of data has been performed Aims and Objectives: We aim to provide the first systematic review and meta-analysis on CT- versus TUS-guided biopsy in the diagnosis of pleural lesions. Methods: We searched Medline and Embase for all studies reporting outcomes of interest published up to April 2018. Summary estimates were derived using the random-effects model. Cumulative meta-analysis assessed the influence of increasing adoption of the procedures over time Results: Thirty original studies were included. The pooled DYs of the two procedures were high and differed less than 10%, being 84% for TUS-guided biopsy and 93% for CT-guided biopsy. Safety was good for both the techniques, with an adverse event rate of 7% and 3% for CT- and TUS-guided biopsy, respectively. DY of the ultrasound technique significantly improved over time, while no time-effect was observed for CT-guided biopsy Conclusions: CT- and TUS-guided pleural biopsy are both sensitive techniques without meaningful differences in DYs and safety. Considering that TUS is non-ionising and easily performed at the bedside, this data suggest that TUS should be the preferred approach in presence of adequate skills, which challenges the current guidelines
Diagnostic yield and safety of image-guided pleural biopsy: a systematic review and meta-analysis
Rota, Matteo;
2020-01-01
Abstract
Background: The diagnostic yield (DY) and safety of computed tomography(CT)-guided and thoracic ultrasound(TUS)-guided biopsy of pleural lesions have been investigated in a number of studies, but no synthesis of data has been performed Aims and Objectives: We aim to provide the first systematic review and meta-analysis on CT- versus TUS-guided biopsy in the diagnosis of pleural lesions. Methods: We searched Medline and Embase for all studies reporting outcomes of interest published up to April 2018. Summary estimates were derived using the random-effects model. Cumulative meta-analysis assessed the influence of increasing adoption of the procedures over time Results: Thirty original studies were included. The pooled DYs of the two procedures were high and differed less than 10%, being 84% for TUS-guided biopsy and 93% for CT-guided biopsy. Safety was good for both the techniques, with an adverse event rate of 7% and 3% for CT- and TUS-guided biopsy, respectively. DY of the ultrasound technique significantly improved over time, while no time-effect was observed for CT-guided biopsy Conclusions: CT- and TUS-guided pleural biopsy are both sensitive techniques without meaningful differences in DYs and safety. Considering that TUS is non-ionising and easily performed at the bedside, this data suggest that TUS should be the preferred approach in presence of adequate skills, which challenges the current guidelinesI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
