Diagnostic Value of Rapid On‐Site Evaluation for CT‐Guided Percutaneous Fine Needle Aspiration in the Diagnosis of Pulmonary Occupying Lesions

Abstract

Objective. Rapid on-site evaluation (ROSE) is an effective and efficient auxiliary examination, but its value for CT-guided percutaneous fine-needle aspiration (FNA) in the diagnosis of pulmonary occupying lesions is unclear. This study is aimed at evaluating the clinical utility of ROSE for CT-guided percutaneous FNA. Methods. We reviewed 234 patients from September 2018 to April 2019. The result using ROSE was compared with the final pathological diagnosis of CT-guided percutaneous FNA, and we also compared the complications between the ROSE group and the NO-ROSE group. The final pathological diagnosis results served as the gold standard. We also analyzed the diagnostic rate of FNA and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of malignancy. The correlation between diverse pathological types of lung cancer was also taken into consideration. Results. In total, 132 patients underwent CT-guided percutaneous FNA with ROSE (ROSE group), and 102 did not (NO-ROSE group). The diagnostic rate, sensitivity, specificity, PPV, and NPV of the ROSE group were 91.6%, 89.1%, 94.1%, 93.4%, and 90.1%, respectively. The complication rates of the ROSE group and the NO-ROSE group were 8.33% and 16.67%, respectively. This difference was not statistically significant ( P > 0.05 ). In subsets of adenocarcinoma (AC) and small cell lung cancer (SCLC) patients, the ROSE result was highly consistent with the final pathological result. Conclusion. CT-guided percutaneous FNA combined with ROSE has a high diagnostic rate, sensitivity, and specificity for pulmonary occupying lesions and an acceptable rate of complications. This method is worthy of wide use given its high efficiency and safety.

Clinical Value of CT-Guided Fine Needle Aspiration and Tissue-Core Biopsy of Thoracic Masses in the Dog and Cat

“…We observed some complications such as 2 mild lung hemorrhages and 17 cases of mild to moderate pneumothoraxes, but the rate was lower than what was previously been reported [ 23 ]. The lower incidence was found with CT-guided percutaneous FNAB, and this result agrees with the reports in human medicine [ 19 , 20 ]. Nevertheless, no complications required further therapeutic intervention.…”

“…In human medicine, the diagnostic accuracy of the core biopsy under CT guidance is reported between 88% [ 16 ] and 95% [ 13 ], with similar results for FNAB, 85% [ 15 ]. In the literature, it has been reported that carcinomas and round cell tumors exfoliate much better than sarcomas [ 1 ], and, since most of the malignancies reported in the lung are carcinomas [ 20 ] and in the mediastinum are lymphomas or thymomas [ 28 , 29 , 30 , 31 ], this may explain why there is quite a high accuracy with CT-guided FNAB in our study. Indeed, 29 cases were epithelial neoplasms, 28 from lungs and 1 from thymus.…”

“…Furthermore, the use of the Doppler examination allows the evaluation of the lesion vascularization [ 1 ]. Nevertheless, in human medicine, CT and CT-guided biopsies, both FNAB and TCB, are recommended in the presence of thoracic lesions which are not adequately visible or accessible with other procedures [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. CT-guide sampling has been reported to be diagnostic in 75–95% of human patients [ 10 , 19 , 20 , 21 ].…”

“…Nevertheless, in human medicine, CT and CT-guided biopsies, both FNAB and TCB, are recommended in the presence of thoracic lesions which are not adequately visible or accessible with other procedures [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. CT-guide sampling has been reported to be diagnostic in 75–95% of human patients [ 10 , 19 , 20 , 21 ]. On the other hand, indications for CT-guided biopsy in dogs and cats include lesions not well identified on radiographs or with fluoroscopy, lesions close to vascular structures, small lesions and lesions surrounded by air or gas which would not be identified with US [ 23 , 24 , 25 , 26 ].…”

Efficacy of rapid on-site cytological evaluation (ROSE) by a pulmonologist in determining specimen adequacy and diagnostic accuracy in interventional diagnosis of lung lesions

“…1 ROSE is recommended in the sampling process to improve diagnostic accuracy, reduce the risk of complications, and enable appropriate specimen triage. [9][10][11] With ROSE, the yield of conventional TBNA is similar to that of EBUS-TBNA and this is especially relevant in the case of sarcoidosis. 12 Even at centers where an EBUS facility is available, conventional TBNA with ROSE can provide a diagnostic yield similar to EBUS.…”