Diagnostic Accuracy of CT-Guided Transthoracic Needle Biopsy for Solitary Pulmonary Nodules

Yang, Wen; Sun, Wenmin; Li, Qian; Yao, Yanwen; Lv, Tangfeng; Zeng, Junli; Liang, Wenjun; Zhou, Xiaojun; Song, Yong

doi:10.1371/journal.pone.0131373

Cited by 85 publications

(103 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Obtaining a tissue biopsy for pathological examination is key to ensuring a prompt and appropriate diagnosis and effective treatment for the pulmonary lesions. In a recent study that evaluated the diagnostic accuracy of CT‐guided PNB for pulmonary lesions, the diagnostic accuracy, sensitivity, and specificity of CT‐guided PNB were reported to be 92.9%, 95.3%, and 95.7%, respectively . In our study, CT‐guided PNB also showed good performance in the diagnosis of pulmonary lesions, and the detection rate could be greatly improved if CT‐guided PNB was combined with EB, reach as high as 90%.…”

Section: Discussionsupporting

confidence: 65%

“…In a recent study that evaluated the diagnostic accuracy of CT-guided PNB for pulmonary lesions, the diagnostic accuracy, sensitivity, and specificity of CT-guided PNB were reported to be 92.9%, 95.3%, and 95.7%, respectively. 9 In our study, CT-guided PNB also showed good performance in the diagnosis of pulmonary lesions, and the detec- 22 Fourth, because of insufficient information, the tumor size was not measured by CT-guided PNB and was not included in the analysis that estimated the association between tumor size and the diagnostic results. Fifth, it should be noted that some, more central lung lesions, are more amenable to EB.…”

Section: Discussionmentioning

confidence: 67%

See 1 more Smart Citation

Comparison of computed tomography‐guided percutaneous needle biopsy and endobronchial biopsy in the diagnosis of multifocal pulmonary lesions

Zheng

et al. 2019

Clinical Laboratory Analysis

View full text Add to dashboard Cite

BackgroundThe retrospective study aimed to compare computed tomography (CT)‐guided percutaneous needle biopsy (PNB) and endobronchial biopsy (EB) in the diagnosis of multifocal pulmonary lesions with endobronchial involvement.MethodsBetween November 2014 and June 2017, consecutive patients who had underwent both CT‐guided PNB and EB via bronchoscopy for diagnosis of pulmonary lesions were evaluated retrospectively. Tissue samples were submitted for pathological examination, acid‐fast bacilli, TB RT‐PCR, and mycobacterial culture. Sensitivities of the two methods alone or in combination were calculated and compared using Fisher's exact test.ResultsSixty‐seven patients (46 men and 21 women) were enrolled and could be diagnosed (32 malignant, 18 TB, and 17 benign). A final diagnosis of either malignant or TB diseases was made in 34 (68.0%) patients for CT‐guided PNBs, 19 (38.0%) patients for EBs, and 42 (84.0%) patients for the combination of both methods. Further statistical analysis showed significant difference in sensitivity between CT‐guided PNBs, or the combination of both methods, and EBs (all P < 0.05), and no difference between CT‐guided PNBs and the combination (P > 0.05). However, the combination of both methods appears to have the highest sensitivity in the detection of malignancies or TB diseases.ConclusionCompared with EB, CT‐guided PNB has a high diagnostic yield for the detection of TB and malignancy in patients with multifocal pulmonary lesions with endobronchial involvement. When the two biopsies are combined, it appears to provide an incremental diagnostic value for the pulmonary lesions.

show abstract

Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 67%

Comparison of computed tomography‐guided percutaneous needle biopsy and endobronchial biopsy in the diagnosis of multifocal pulmonary lesions

Zheng

et al. 2019

Clinical Laboratory Analysis

View full text Add to dashboard Cite

show abstract

“…However, PTNB has been known to have major complications of pneumothorax and pulmonary hemorrhage, with reported incidence rates of 10-40% and 26-33%, respectively (63). In our previous study (47), there were 55 cases of pneumothorax (17.7%), 2 cases needed thoracentesis and 1 case needed chest tube drainage. In addition, the diagnostic yield was influenced by size of the lesion, size of the needle, number of passes, and use of rapid on-site evaluation (64,65).…”

Section: Discussionmentioning

confidence: 82%

“…Since Haaga and Alfidi reported the first case of CT-PTNB in 1976 (62), the procedure had been constantly developed and is currently widely employed as a routine diagnostic technique for PPLs, owing to its simplicity and minimal invasiveness. Recently, we performed a Transl Lung Cancer Res 2017;6(1):23-34 tlcr.amegroups.com retrospective study (47) to evaluate the diagnostic accuracy of CT-PTNB for SPN. Out of the 311 patients with SPN, 2 were false-positive cases, 12 were false-negative cases, and 8 were undiagnosed, resulting in a 92.9% diagnostic accuracy of CT-PTNB.…”

Section: Discussionmentioning

confidence: 99%

Comparison between endobronchial ultrasound-guided transbronchial biopsy and CT-guided transthoracic lung biopsy for the diagnosis of peripheral lung cancer: a systematic review and meta-analysis

Zhan¹,

Zhu²,

Miu³

et al. 2017

Transl. Lung Cancer Res.

Self Cite

View full text Add to dashboard Cite

Background: With the release of the National Lung Screening Trial results, the detection of peripheral pulmonary lesions (PPLs) is likely to increase. Computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) and radial probe endobronchial ultrasound (r-EBUS)-guided transbronchial lung biopsy (TBLB) are recommended for tissue diagnosis of PPLs.Methods: A systematic review of published literature evaluating the accuracy of r-EBUS-TBLB and CT-PTNB for the diagnosis of PPLs was performed to determine point sensitivity and specificity, and to construct a summary receiver-operating characteristic curve.Results: This review included 31 publications dealing with EBUS-TBLB and 14 publications dealing with CT-PTNB for the diagnosis of PPLs. EBUS-TBLB had point sensitivity of 0.69 (95% CI: 0.67-0.71) for the diagnosis of peripheral lung cancer (PLC), which was lower than the sensitivity of CT-PTNB (0.94, 95% CI: 0.94-0.95). However, the complication rates observed with EBUS-TBLB were lower than those reported for CT-PTNB.Conclusions: This meta-analysis showed that EBUS-TBLB is a safe and relatively accurate tool in the investigation of PLC. Although the yield remains lower than that of CT-PTNB, the procedural risks are lower.Keywords: Computed tomography-guided percutaneous transthoracic needle biopsy (CT-PTNB); radial probe endobronchial ultrasound-guided transbronchial lung biopsy (r-EBUS-TBLB); peripheral pulmonary lesions; diagnosis; meta-analysis

show abstract

“…It has been reported Original Article CT-guided transthoracic core needle biopsy for small pulmonary lesions: diagnostic performance and adequacy for molecular testing that the diagnostic accuracy of FNAB is decreased for small lesions (3,4). CT-guided transthoracic needle biopsy is a safe technology that is easy to operate, with a diagnostic accuracy for pulmonary lesions that reaches 64-97% (5)(6)(7)(8). Therefore, this procedure has become one of the major methods for determining the nature of pulmonary lesions.…”

Section: Introductionmentioning

confidence: 99%

CT-guided transthoracic core needle biopsy for small pulmonary lesions: diagnostic performance and adequacy for molecular testing

Tian¹,

Wang²,

Li³

et al. 2017

J. Thorac. Dis.

View full text Add to dashboard Cite

Background: Computed tomography (CT)-guided transthoracic needle biopsy is a well-established, minimally invasive diagnostic tool for pulmonary lesions. Few large studies have been conducted on the diagnostic performance and adequacy for molecular testing of transthoracic core needle biopsy (TCNB) for small pulmonary lesions.Methods: This study included CT-guided TCNB with 18-gauge cutting needles in 560 consecutive patients with small (≤3 cm) pulmonary lesions from January 2012 to January 2015. There were 323 males and 237 females, aged 51.8±12.7 years. The size of the pulmonary lesions was 1.8±0.6 cm. The sensitivity, specificity, accuracy and complications of the biopsies were investigated. The risk factors of diagnostic failure were assessed using univariate and multivariate analyses. The sample's adequacy for molecular testing of non-small cell lung cancer (NSCLC) was analyzed.Results: The overall sensitivity, specificity, and accuracy for diagnosis of malignancy were 92.0% (311/338), 98.6% (219/222), and 94.6% (530/560), respectively. The incidence of bleeding complications was 22.9% (128/560), and the incidence of pneumothorax was 10.4% (58/560). Logistic multivariate regression analysis showed that the independent risk factors for diagnostic failure were a lesion size ≤1 cm [odds ratio (OR), 3.95; P=0.007], lower lobe lesions (OR, 2.83; P=0.001), and pneumothorax (OR, 1.98; P=0.004). Genetic analysis was successfully performed on 95.45% (168/176) of specimens diagnosed as NSCLC. At least 96.8% of samples with two or more passes from a lesion were sufficient for molecular testing. Conclusions:The diagnostic yield of small pulmonary lesions by CT-guided TCNB is high, and the procedure is relatively safe. A lesion size ≤1 cm, lower lobe lesions, and pneumothorax are independent risk factors for biopsy diagnostic failure. TCNB specimens could provide adequate tissues for molecular testing.

show abstract

Diagnostic Accuracy of CT-Guided Transthoracic Needle Biopsy for Solitary Pulmonary Nodules

Cited by 85 publications

References 17 publications

Comparison of computed tomography‐guided percutaneous needle biopsy and endobronchial biopsy in the diagnosis of multifocal pulmonary lesions

Comparison of computed tomography‐guided percutaneous needle biopsy and endobronchial biopsy in the diagnosis of multifocal pulmonary lesions

Comparison between endobronchial ultrasound-guided transbronchial biopsy and CT-guided transthoracic lung biopsy for the diagnosis of peripheral lung cancer: a systematic review and meta-analysis

CT-guided transthoracic core needle biopsy for small pulmonary lesions: diagnostic performance and adequacy for molecular testing

Contact Info

Product

Resources

About