Guidelines For Percutaneous Transthoracic Needle Biopsy

Sokolowski, Joseph W.; Burgher, Louis W.; Jones, Frederick L.; Patterson, James R.; Selecky, Paul A.

doi:10.1164/ajrccm/140.1.255

Cited by 36 publications

(11 citation statements)

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“…The use of automated biopsy devices for transthoracic lung biopsy would result in routine histologic specimens, which might increase the accuracy of the diagnosis of benign disease, thymoma, and lymphoma, which are difficult to diagnose from cytologic samples [9,10]. Furthermore, the need for an experienced cytopathologist in the radiology suite might be diminished, a requirement that was highly recommended by the American Thoracic Society [17], and its value was proved in a recent study [18]. This point would be specially advantageous in Europe because experienced cytopathologists are rare, and in most settings it is impossible for a cytopathologist to attend the biopsy procedure.…”

Section: Discussionmentioning

confidence: 99%

Postmortem evaluation of four randomly selected automated biopsy devices for transthoracic lung biopsy

Wagner

Barth

Schade‐Brittinger

et al. 1995

Cardiovasc Intervent Radiol

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Section: Discussionmentioning

confidence: 99%

Postmortem evaluation of four randomly selected automated biopsy devices for transthoracic lung biopsy

Wagner

Barth

Schade‐Brittinger

et al. 1995

Cardiovasc Intervent Radiol

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“…determine its use in individual cases". 6 In narrative overviews of the use of TNAB in localised pulmonary lesions, sensitivity of TNAB for the diagnosis of malignancy was reported to range from 64% to 100%. 7 8 Similarly, sensitivity of TNAB for the specific benign diagnosis was reported to range from 11.7% to 68%.…”

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confidence: 99%

Transthoracic needle aspiration biopsy for the diagnosis of localised pulmonary lesions: a meta-analysis

Lacasse

Wong²,

Guyatt³

et al. 1999

Thorax

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Background-Persisting controversy surrounds the use of transthoracic needle aspiration biopsy (TNAB) stemming from its uncertain diagnostic accuracy. A systematic review and meta-analysis was therefore conducted to evaluate the accuracy of TNAB for the diagnosis of solitary or multiple localised pulmonary lesions. Methods-Searches for English literature papers in Index Medicus (1963)(1964)(1965) and Medline (1966Medline ( -1996 were performed and the bibliographies of the retrieved articles were systematically reviewed. Articles evaluating the accuracy of TNAB in series of consecutive patients presenting with solitary or multiple pulmonary lesions were considered. Only papers in which >90% of patients were given a final diagnosis according to an appropriate reference standard were included in the meta-analysis. Results-A total of 48 studies were included and five meta-analyses were conducted according to four diagnostic thresholds. From the pooled sensitivity and specificity corresponding to each diagnostic threshold, associated likelihood ratios (LRs) were derived for malignant disease as follows: (1) malignant versus all other categories, LR = 72; (2) malignant or suspicious versus all others, LR = 49; (3) suspicious versus all categories but malignant, LR = 15; (4) benign versus all others, LR = 0.07; and (5) specific benign diagnosis versus all others, LR = 0.005. DiVerences in methodological quality of the studies, needle types, or whether a cytopathologist participated in the procedure failed to explain the heterogeneity of the results found in almost every metaanalysis. Given a 50% probability of malignancy prior to the TNAB, post-test probabilities of malignancy upon receiving the results would be malignant, 99%; suspicious, 94%; non-specific benign, 7%; and benign with a specific diagnosis, 0.6%. Conclusions-Given the intermediate pre-test probabilities that would probably lead to performing TNAB, findings of "malignant" or of a specific diagnosis of a benign condition provide definitive results. Findings of "suspicious" markedly increase the probability of malignancy, and "benign" markedly decreases it but may not be considered definitive.

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“…The indications for the biopsy technique complied with ATS guidelines (12). Contraindications were: no consent from patient or his/her representative; severe coagulation disorders (platelets < 60 x 10 9 /l or prothrombin activity < 60%); suspected vascular lesion; suspected hydatidosis; patients needing assisted ventilation; severe pulmonary hypertension; chronic obstructive pulmonary disease with bullae documented by radiography; and lesions less than I em in diameter.…”

Section: Methodsmentioning

confidence: 99%

Value OF CT-Guided Fine Needle Aspiration in Solitary Pulmonary Nodules with Negative Fiberoptic Bronchoscopy

Río¹,

Lobato²,

Pino³

et al. 1994

Acta Radiol

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The usefulness of fine needle aspiration (FNA) with CT -guidance was evaluated in the diagnosis of solitary pulmonary nodules (SPN) following negative fiberoptic bronchoscopy in 84 patients. The records were analyzed for all patients with SPN who had undergone chest FNA in the years 1988 to 1990, showing previous nondiagnostic fiberoptic bronchoscopy. A final diagnosis was made by biopsy (transbronchial, thoracotomy or necropsy), response to therapy or follow-up of the lesions. The patients had medium-sized lesions, 2.87 ± 1.11 em, adherent to the pleura in 62%. In the diagnosis of malignancy FNA showed 76% sensitivity, 100% specificity, 100% positive predictive value, 52% negative predictive value and 81% accuracy. These results were correlated with histology in 84% of the cases. One pulmonary hemorrhage, which resolved spontaneously, and 12 cases of pneumothorax, requiring a thoracic tube in 4 patients, were noted.

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Guidelines For Percutaneous Transthoracic Needle Biopsy

Cited by 36 publications

References 1 publication

Postmortem evaluation of four randomly selected automated biopsy devices for transthoracic lung biopsy

Postmortem evaluation of four randomly selected automated biopsy devices for transthoracic lung biopsy

Transthoracic needle aspiration biopsy for the diagnosis of localised pulmonary lesions: a meta-analysis

Value OF CT-Guided Fine Needle Aspiration in Solitary Pulmonary Nodules with Negative Fiberoptic Bronchoscopy

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