Diagnostic result and cost of ultrasound-guided percutaneous puncture in peripheral lung lesions made by pulmonologists

Introduction: The ultrasound (US) is a complementary test for peripheral lung lesions (PLL) in contact with the chest wall,and is used as a guide in percutaneous puncture (PC) as it offers advantages compared to other tests. Aim: to determine the diagnostic result,complications and costs of the percutaneous US-guided PC in PLL by pulmonologists. Methods: A retrospective analysis of 24 patients, collected from April to December 2015,with PLL visualized by thorax CT previously who underwent US-guided transthoracic PC in outpatient clinic at University Hospital of the Canary. Results: 24 patients were analyzed. Distribution of lesions:38% in right upper lobe,29% in lower right lobe,17% in left lower lobe,8% in left upper lobe,4% in middle lobe and pleuroparietal at 4%. Lesion size, smaller than 2 cm was 16.6%,a size between 2 and 5 cm was 27.5% and greater than 5 cm was 45.8%. The diagnostic result of cytology obtained by the percutaneous US-guided PC in PLL was 58% and suspicious for malignancy in 21%. The diagnostic result obtained by percutaneal core biopsy was 91.7%. The final diagnosis;1)Malignant lesions:non-small 25%, 29% small cell, metastasis 4.1%, 4.1% mesothelioma and other tumors 17%. 2)Inconclusive at 8.3%. 3)Benign lesions in 12.5%. The only complication was mild hemoptysis self-limited in two patients. The cost of the procedure was 188€ compared to a cost of 1479€ of CT-guided procedure. The total cost savings was 30,936€. Conclusions: -The diagnostic yield was similar results to other studies. -There was no relationship between the size of the peripheral lung lesion and diagnostic result. -Comfort and less radiation for the patient with fewer health expenses.