Artis zee multipurpose system

The pathologic specimens were obtained by surgical resection (n = 9) or CT-guided (n = 3), fluoroscopy-guided (n = 1), or bronchoscopy-guided (n = 1) core-needle biopsy (Table 1). The CT-guided procedures were performed using a 16-channel SOMATOM Sensation (Siemens Medical Solutions, Forchheim, Germany). To perform the fluoroscopy-guided procedures, the Siemens Artis zee multipurpose system (Siemens AG, Muenchen, Germany) was used. Biopsies were carried out with a 20-gauge semiautomatic core biopsy needle (Stericut with a coaxial guide, TSK Stericut; TSK, Laboratory, Soja, Japan). After the pleura had been punctured, biopsies were performed 2 or 3 times with the patient holding their breath to get sufficient tissue for diagnosis.
The pathologic specimens were fixed in 10% formalin, paraffin-embedded, and sectioned for hematoxylin and eosin staining and immunohistochemistry. Two pathologists primarily reviewed all the specimens, and 1 expert thoracic pathologist (J.S.S.) examined them to obtain detailed pathologic findings. PPSS was diagnosed based on morphology and immunohistochemical findings. Reverse transcriptase polymerase chain reaction was used to detect SYT-SSX1/2 fusion transcripts in 6 patients (Supplementary Table 1, http://links.lww.com/MD/A385).

Among 76 patients, 58 patients (76.3%) were diagnosed by either CT or fluoroscopy-guided core-needle biopsy. CT-guided core needle biopsies were performed using 16-channel SOMATOM Sensation (Siemens Medical Solutions, Forchheim, Germany) CT and fluoroscopy-guided core needle biopsies were performed using Siemens Artis zee multipurpose system (Siemens AG, Muenchen, Germany). These procedures were performed with a 20-gauge semiautomatic core biopsy needle (Stericut with coaxial guide, TSK Stericut; TSK Laboratory, Soja, Japan). One to 3 times of biopsies were done with patients’ breath holding during each procedure in order to get sufficient tissues for diagnosis (Table 1).

Of the 47 patients, 41 (87.2%) were pathologically confirmed by fluoroscopy or CT-guided core-needle biopsy (Table 1). CT-guided core needle biopsies were performed with a 16-channel CT SOMATOM Sensation (Siemens Medical Solutions, Forchheim, Germany), and fluoroscopy-guided core needle biopsies were performed using a Siemens Artis zee multipurpose system (Siemens AG, Muenchen, Germany). All procedures were performed by expert chest radiologists with an 18- or 20-gauge semiautomatic core biopsy needle (Stericut with coaxial guide, TSK Stericut; TSK Laboratory, Soja, Japan). Two or 3 biopsies were performed at each procedure in order to obtain sufficient specimen for diagnosis.