Feasibility of CT-Guided Percutaneous Needle Biopsy in Early Diagnosis of BOOP

• Published in: Cardiovascular and interventional radiology 2008-09, Vol.31 (5), p.1003-1007
• Main Authors: Poulou, Loukia S., Tsangaridou, Iris, Filippoussis, Petros, Sidiropoulou, Nektaria, Apostolopoulou, Sofia, Thanos, Loukas
• Format: Article
• Language: English
• Subjects: Adult; Aged; BIOPSY; Biopsy, Needle - methods; BODY; Bronchoalveolar Lavage Fluid - cytology; Cardiology; Cohort Studies; COMPUTERIZED TOMOGRAPHY; Cryptogenic Organizing Pneumonia - diagnosis; Cryptogenic Organizing Pneumonia - diagnostic imaging; Cryptogenic Organizing Pneumonia - pathology; DIAGNOSIS; DIAGNOSTIC TECHNIQUES; DISEASES; Early Diagnosis; Feasibility Studies; Female; Follow-Up Studies; Humans; Imaging; Immunohistochemistry; LUNGS; Male; Medicine; Medicine & Public Health; Middle Aged; NEOPLASMS; Nuclear Medicine; ORGANS; PNEUMONIA; Radiography, Interventional - methods; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; RESPIRATORY SYSTEM; RESPIRATORY SYSTEM DISEASES; Risk Assessment; Sensitivity and Specificity; Severity of Illness Index; Technical Note; TOMOGRAPHY; Tomography, X-Ray Computed - methods; Ultrasound
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-007-9290-4

Bronchiolitis obliterans organizing pneumonia (BOOP) is a nonneoplastic, noninfectious lung disease with a diverse spectrum of imaging abnormalities and nonspecific symptoms diagnosed by open lung biopsy, transbroncial biopsy, and/or video-assisted thoracoscopy. The objective of this study was to retrospectively assess the role of percutaneous computed tomography (CT)-guided biopsy in early diagnosis of the disorder. Fourteen BOOP cases diagnosed by CT-guided biopsy were analyzed in terms of imaging abnormalities and complication rate. All had previously undergone a nondiagnostic procedure (bronchoscopy, transbronchial biopsy, bronchoalveolar lavage) to exclude infection or lung cancer. The most common imaging abnormalities in descending order were bilateral consolidations (5/14), unilateral tumor-like lesions (5/14), unilateral consolidations (3/14), and diffuse reticular pattern (1/14). Coexistent abnormalities (pleural effusions, nodules, ground-glass opacities) were observed in five patients. The complication rate was 4 of 14 (28.6%), including 2 cases of subclinical pneumothorax and 1 case of minor hemoptysis and local lung injury. None required intervention. We conclude that transthoracic CT-guided biopsy may be used in the diagnosis of BOOP in selected patients with mild complications. For the focal consolidation nodule/mass imaging pattern, CT-guided biopsy may prove to be a reasonable alternative to more invasive procedures.