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Imaging-Guided Percutaneous Endovascular Biopsy Applied in Patients with Pulmonary Artery Masses: A Review

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Abstract

Introduction

Pulmonary artery (PA) masses are rare. Distinguishing PA tumours from embolism is sometimes difficult, and surgical biopsy is expensive and risky. We aimed to evaluate the efficacy of imaging-guided percutaneous endovascular biopsy (PEB) for obtaining tissues for histological diagnosis.

Methods

We searched Cochrane, Medline, Embase, and Web of Science for PEB trials involving patients with PA masses, published from the inception of the database until August 2023.

Results

We retrospectively reviewed 33 studies including 87 patients (median age 55 ± 69.3 years, 44 men) with PA masses who underwent a total of 110 PEBs. Of these patients, 34.5% (n = 38) underwent PEB-catheter aspiration (PEB-CA), 50.9% (n = 56) underwent PEB-forceps biopsy (PEB-FB) and 2.7% (n = 3) underwent PEB-directional atherectomy (PEB-DA). The most common histological aetiology of PA masses was mesenchymal tumours (n = 67, 75.9%). Tumour embolism (n = 6, 6.9%) and pulmonary embolism (n = 3, 3.4%) were the second and third most common types of PA masses, respectively. The technical success rates of PEB-CA, PEB-FB and PEB-DA were 92.1%, 94.6% and 100% (p = 0.796), respectively. Histopathological analysis provided clinical diagnostic success rates of 44.7%, 85.7% and 100% for PEB-CA, PEB-FB and PEB-DA (p < 0.001), respectively. In pairwise comparison, PEB-FB had a higher success rate in pathological diagnosis than PEB-CA (p = 0.000). Apart from one patient suffering from haemorrhagic cardiac tamponade, no other complications occurred.

Conclusion

Imaging-guided PEB is a safe and effective technique for the early pathological diagnosis of PA masses.

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Data Availability

The data and materials during the this study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank the participants of the study.

Medical Writing/Editorial Assistance

The Editage company provided medical writing assistance.

Funding

This study was supported by grants from the Natural Science Foundation of Sichuan (Grants 2022NSFSC0693). The Rapid Service Fee was funded by the authors.

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Author notes

  1. Hongxia Wu and Kaiquan Zhuo contributed equally and are co-first authors to this work.

Authors and Affiliations

  1. Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China

    Hongxia Wu, Li Guo, Faming Jiang, Ye Wang & Deyun Cheng

  2. Department of Neurology, The People’s Hospital of Pengzhou, Chengdu, China

    Kaiquan Zhuo

  3. State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China

    Hongxia Wu, Li Guo, Faming Jiang, Ye Wang & Deyun Cheng

  4. Department of Respiratory, Traditional Chinese Medicine Hospital of Meishan, Meishan, China

    Bo Zhang

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Contributions

Kai Quan Zhuo and Hong **a Wu initiated and coordinated the study. Kai Quan Zhuo, Li Guo, Fa Ming Jiang and Bo Zhang were responsible for study selection and data collection. Kai Quan Zhuo and Hong **a Wu wrote the first draft of the manuscript. Studies were reviewed by Ye Wang and De Yun Cheng. All authors read and approved the final manuscript. All authors contributed to the article and approved the submitted version.

Corresponding authors

Correspondence to Ye Wang or Deyun Cheng.

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Conflict of Interest

Hong **a Wu, Kai Quan Zhuo, Li Guo, Fa Ming Jiang, Bo Zhang, Ye Wang and De Yun Cheng have nothing to declare.

Ethical Approval

This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.

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Wu, H., Zhuo, K., Guo, L. et al. Imaging-Guided Percutaneous Endovascular Biopsy Applied in Patients with Pulmonary Artery Masses: A Review. Adv Ther (2024). https://doi.org/10.1007/s12325-024-02903-z

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