Comparison of contrast-enhanced ultrasound and conventional ultrasound for guiding peripheral pulmonary biopsies

Objective: To compare the clinical value of CEUS vs. conventional ultrasound for guiding peripheral pulmonary biopsies of space-occupying lesions. Methods: This was a retrospective study of the patients that underwent a US-or CEUS-guided lung biopsy between January 2013 and August 2015 at the Zhongshan Hospital affiliated to Fudan University. CEUS examination was performed using the SonoVue contrast agent. Patients underwent CEUSor US-guided lung biopsy. Results: Patient characteristics were similar between the two groups, but lesions were larger (P=0.017) in the CEUS group. The success rate of CEUS-guided biopsies was better than that of US-guided biopsies (97.5% vs. 86.3%, P=0.002). When distinguishing malignant from benign lesions, for CEUS, sensitivity was 95.1%, specificity was 100.0%, positive predictive value was 100.0%, and negative predictive value was 90.9%, for an overall accuracy of 96.7%, compared with 94.7%, 100.0%, 100.0%, 93.2%, and 97.0% for US. When considering the individual diagnoses, consistency between biopsy and surgery was 95.9% for CEUS-guided lung biopsy, compared with 87.0% for US-guided lung biopsy (P=0.013). In the US group, there were three cases of hemoptysis, one of pneumothorax, and one of chest pain. In the CEUS group, there were one case of hemoptysis and one of chest pain. Conclusion: CEUS-guided biopsy of peripheral pulmonary lesions could have a better diagnostic accuracy than that of US-guided biopsy, and could be associated with less complication.