OBJECTIVE: Investigate radiologic and radiometabolic features affecting the diagnostic success of transthoracic biopsy (TTB) procedures guided by Thoracic Ultrasonography (TUS).
METHODS: The electronic medical records of all patients who underwent TUS guided TTB procedures (TUS-TBB) were retrospectively reviewed. Patients with a final diagnosis of primary lung cancer (LC), established via TUS-TBB or other diagnostic modalities, were included in the study. The cohort was stratified into two groups: those in whom the TUS-TBB procedure was diagnostic and those in whom it was non-diagnostic. Clinical, demographic, radiological [Chest Computed Tomography (CT)] and radiometabolic (PET-CT) characteristics were compared between the two groups.
RESULTS: A total of 107 patients with a final diagnosis of lung cancer were included in the study. Of these, 91 (85%) were male, with a mean age of 67.8 ± 11.4 years. The mean maximum diameter of the mass lesion on chest CT was 68.2 ± 31 millimeters (mm), and the mean maximum standardized uptake value (SUV-Max) on PET-CT was 14.1 ± 6.9. A necrotic component/ametabolic area within the lesion on PET-CT was present in 43 (40.2%) patients and absent in 64 (59.8%). The most frequent histopathological subtype was adenocarcinoma, observed in 46 (42.9%) cases. While 41 (38.3%) patients underwent transthoracic fine-needle aspiration biopsy (TTFNAB) under TUS guidance, 66 (61.7%) patients underwent tru-cut biopsy (TCB).
The TUS-TBB procedure was diagnostically successful in 87 (81.3%) of the cases. The presence of a necrotic component within the lesion on PET-CT was identified as the sole independent risk factor significantly impacting the diagnostic success of the procedure (p = 0.010).
CONCLUSION: TUS-TBB procedures demonstrate high diagnostic success. In carefully selected patients, pre-procedural evaluation of lesion metabolic activity using PET-CT may enhance the diagnostic success of the biopsy. (NCI-2025-7-9)

Keywords: Biopsy, positron emission tomography, thoracic ultrasonography, transthoracic biopsy, suvmax.

Torasik ultrasonografi rehberliðinde biyopsi: Taný baþarýsýna etkili radyolojik ve radyometabolik faktörler

Amaç: Torasik Ultrasonografi (TUS) rehberliðinde transtorasik biyopsi (TTB) iþlemlerinin tanýsal baþarýsýna etki eden radyolojik ve radyometabolik özellikleri araþtýrmak.
Metod: TUS rehberliðinde TTB (TUS-TTB) iþlemi yapýlan tüm olgularýn dosyalarý elektronik ortamda incelendi. Final tanýsý TUS-TTB ile veya baþka bir yöntem ile primer akciðer kanseri (AK) olan olgular çalýþmaya dahil edildi. Olgular TUS-TTB iþleminin tanýsal olduðu grup ve tanýsal olmadýðý grup olarak ikiye ayrýldý. Ýki grup arasýnda klinik, demografik, radyolojik [Toraks Bilgisayarlý Tomografi (BT)] ve radyometabolik (PET-BT) özellikler karþýlaþtýrýldý.
Bulgular: Çalýþmaya final tanýsý AK olan toplam 107 olgu dahil edildi. Olgularýn 91’i (%85) erkek, yaþ ortalamasý 67.8±11.4’dü. Ortalama toraks BT’de kitle lezyon uzun çapý 68.2±31 milimetre (mm), ortalama PET-CT’de lezyon SUV-Max deðeri 14.1±6.9’dü. 43 (%40.2) olguda PET-CT’de lezyonda nekrotik komponent/ametabolik alan var iken 64 (%59.8) olguda yoktu. En sýk görülen histopatolojik alt tip 46 (%42.9) ile adenokarsinomdu. 41 (%38.3) olgu TUS rehberliðinde ince iðne aspirasyon biyopsi (ÝÝAB ) yapýlmýþ iken, 66 (%61.7) olguya tru-cut biyopsi (TCB) yapýlmýþtý.
TUS-TTB yapýlan olgularýn 87’sinde (%81.3) iþlem tanýsal olarak baþarýlý olmuþtu. Ýþlemlerinin tanýsal baþarýsýna etkili tek baðýmsýz risk faktörlerü PET-CT’de lezyonun nekrotik komponent varlýðý barýndýrmasý olarak bulundu (p=0.010).
Sonuç: TUS-TTB iþlemleri tanýsal baþarýsý yüksek iþlemlerdir, seçilmiþ olgularda iþlem öncesi lezyonlarýn metabolik aktivitesinin PET-BT ile deðerlendirilmesi, biyopsi iþleminin taný baþarýsýný artýrabilir.

Anahtar Kelimeler: Biyopsi, pozitron-emisyon tomografi, torasik ultrasonografi, transtorasik biyopsi, suvmax deðeri