Percutaneous ultrasound-guided punctures and biopsies in the diagnosis of peripheral thoracic lesions for pulmonologists

Introduction: The use of ultrasound (US) in peripheral thoracic lesions (PTL) is performed mainly by interventional radiologists and most studies applying this procedure have been published by radiologists. Aim: To determine the diagnostic efficacy of the percutaneous US-guided punctures of PTL performed by pulmonologists. Methods: A retrospective analysis of 58 patients who had underwent US-guided transthoracic punctures of PTL demonstrated with computed tomography, collected from March 2011 and September 2014 in our pneumology department. Results: The sites of the lesions were pulmonary in 51 cases(88%),mediastinal in 3 cases(5%),pleuro-parietal in 2 cases(3.5%) and supraclavicular in 2 cases(3.5%). In 47 procedures was obtained a concluding diagnostic (81%),13 with specific benign lesions and 34 with cancers. In the remaining 11 patients(19%) we obtained a non-diagnostic (ND) result without evidence of malignancy. A false-negative result was determined in 6 of these 11 ND procedures by an alternative diagnostic technique. The sensitivity was 88.68%,the negative predictive value was 45.45% and the overall diagnostic accuracy was 89.66%. Conclusions: The percutaneous US-guided punctures in the diagnosis of PTL performed by pulmonologists is a procedure with high diagnostic accuracy. We achieved similar results to those previously obtained by radiologists.