1. CT-guided percutaneous transthoracic needle biopsy of lung lesions - 2-year experience at the Institute of radiology in LjubljanaIgor Kocijančič, Ksenija Kocijančič, 2007, izvirni znanstveni članek Povzetek: Background. In 1883, Leyden described percutaneous lung biopsy, but it was notuntil 1970s that image guided fine needle chest biopsy gained widespread acceptance. Haaga and Alfidi reported CT-guided thoracic biopsy in 1976. Currently, tissue sampling of a thoracic lesion is indicated when the diagnosis is not obtained by the endobronchial technique and when the cytological diagnosis will modify the stage of the disease or influence the therapeutic strategy. Cytology obtained by small-gauge needle aspiration biopsy confirms the nature of the lesion in 80 - 95% of cases and carry a low incidence of major complications according to the literature. The purpose of this retrospective analysis was to provide basic data about diagnostic accuracy and incidence of pneumothorax and chest tube insertion with respect to percutaneous transthoracic CT-guided needle biopsy of lung lesions. Methods. After positioning of the patient we performed a spiral CT of the thorax with the accordingly placed metal mark, which helped us to set the optimal cutaneous entry point. After that we re-checked the localisation of the lesion and marked the entry point with a pen and clean the surface to keepit sterile. After we applied local anaesthetic subcutaneously, we used coaxial 18G Gallini aspiration biopsy needles with cutting tip for CT- guided aspiration cytologic examination. The length of the needle was chosen according to the distance of the targeted lesion. Results. From January 2005 to January 2007 forty-three patients - 24 men and 19 women who were 26-79 years old (mean +/- SD, 59.8 +/- 10 years) were referred to the Institute of Radiology to undergo the PTNB. One patient was referred twice. Consequently, the hospital records and images of 44 consecutive cases of percutaneous transthoracic fine needle aspiration biopsy procedure were retrospectively analysed. (Abstract truncated at 2000 characters)
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2. Radiofrequency ablation of lung tumours - new perspective in treatment of lung neoplasmsKsenija Kocijančič, Igor Kocijančič, 2007, izvirni znanstveni članek Povzetek: Background. Percutaneous radiofrequency ablation (RFA) is a minimally invasivetechnique used to treat solid tumours. Because of its ability to produce large volume of coagulation necrosis in controlled fashion this technique has been progressively tested as a possible treatment of lung malignancies. Recent clinical studies have shown that RFA enables successful treahnent of relatively small lung malignancies with high rate of complete response and acceptable morbidity and have suggested that the technique could represent a viable alternate or complementary method for patients with non-small cell lung cancer or lung metastases of favourable histotypes who arenot candidates for surgical resection. Conclusions. Initial intenational studies as well as the clinical experience of Institute of Radiology in Clinical Center Ljubljana, although limited, indicated that RFA is mostly welltolerated by patients and also, that it can result in complete necrosis oftargeted lesion. Pneumothorax is most common procedure related complication,occurring in up to 40% of cases, with approx. half of them requiring drainage.
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3. How reliable is classic chest radiography in the diagnosis of small pleural effusionIgor Kocijančič, Ksenija Kocijančič, 1999, izvirni znanstveni članek Povzetek: Purpose. To evaluate the usefulness of expirium lateral decubitus views in theradiological diagnosis of small pleural effusions. Materials and methods. Patients referred to abdominal sonography for different reasons were routinelychecked for possible pleural effusion. From November 1994 till May 1996, 36 such patients were found to have pleural effusion not exceeding 15 mmand were included in the study. Patients were examined radiologically in erect PA and lateral projections and, after 5 min. in decubitus position, in inspiratory-expiratory lateral decubitus projections with 10 hip elevation andcentral beam on the lateral chest wall. Results. In 22 out of 36 patients (61 %), the pleural fluid was not visible on erect PA and lateral chest radiogram. However, the fluid was visible in 35/36 patients (97%) in expirium from lateral decubitus view. The average thickness of fluid from lateral decubitus views in inspirium and expirium was 4.3 and 7.9 mm, respectively. In31 out of 36 patients (86%), the thickness of the fluid layer as measured inexpirium and inspirium was different. In 16%, the fluid was not visible on inspirium lateral decubitus projections. Conclusions. Radiography turned out to be almost as sensitive as sonography in detection of small pleural effusions. Lateral decubitus views taken in expirium contributed essentially to the diagnostic sensitivity in our study.
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