Factors influencing accuracy of CT-guided percutaneous biopsies of pulmonary lesions

Abstract

The purpose of this study was to evaluate the performance and complication rate of CT-guided percutaneous lung biopsy of pulmonary lesions using a coaxial automated biopsy device and to determine factors influencing the false negative rate for the diagnosis of malignancy. A prospective study of 605 consecutive biopsies performed in 595 patients was undertaken. The performances for the diagnosis of malignancy, for the specific diagnosis of benignity and the complication rate were calculated. Patients' characteristics and lesion and procedure variables were included in a logistic regression model and analyzed as potential predictive variables for occurrence of a false-negative diagnosis of malignancy. The sensitivity, specificity, positive predictive value and negative predictive value for a diagnosis of malignancy were 92.2, 99.1, 99.8 and 73.3%, respectively. A specific diagnosis of benignity was obtained in 43 cases (40%) biopsies. The pneumothorax rate was 17.4% (n = 105) with 3 (0.5%) requiring drainage. At multivariate analysis, the sole variable significantly associated with a higher rate of false negative diagnosis of malignancy was lesion size equal to or smaller than 10 mm in diameter. Using a coaxial automated device, CT-guided percutaneous biopsy of pulmonary lesions of size equal to or less than 10 mm in diameter provides a high diagnostic yield with an acceptable complication rate.

Diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy of pulmonary lesions with non-coaxial technique: a single center experience with 442 biopsies

“…To our knowledge, there are only few studies on transthoracic biopsy using FNA and non-coaxial technique in recent literature (11,12). Table 5 summarizes some of the previous studies performed by other investigators (2,4,5,9,10,14,15). In the present study, the diagnostic accuracy was 97.6%, with 97.3% sensitivity and 100% specificity for malignant disease.…”

Needle Gauge and Cytological Yield in CT-Guided Lung Biopsy

“…The sensitivity of lung biopsy in this study was 90.4%, which is comparable to other studies [3][4][5]11]. This high sensitivity adds support to the efficacy of CT-guided needle biopsy for evaluation of pulmonary nodules in the presence of on-site cytologist.…”

“…Percutaneous CTguided needle lung biopsy has a high diagnostic accuracy and is a well-established procedure for obtaining a cytological evaluation of pulmonary nodules [2,3]. Factors affecting diagnostic accuracy are lesion size, immediate on-site sample evaluation by a cytologist, and technique, including type of biopsy device [4][5][6][7][8][9][10]. A previous study has shown core biopsies to be a more accurate method of tissue sampling without increasing risk of complications when compared to fine-needle aspiration [11].…”

Utilidad de la biopsia percutánea core guiada por tomografía computada (TC) en lesiones pulmonares: experiencia de 7 años

“…El tamaño lesional es un factor importante y ampliamente estudiado, con una menor sensibilidad de la técnica reportada en lesiones menores a 15 mm y mayores a 5 cm, estas últimas por un mayor porcentaje de necrosis asociada 6,19 . En nuestro estudio no observamos una relación entre el tamaño de la lesión y el rendimiento de la técnica, probablemente por el bajo porcentaje de lesiones menores a 20 mm.…”