Transthoracic Fine Needle Aspiration Biopsy

Layfield, Lester J.; Coogan, Alice; Johnston, William W.; Patz, Edward F.

doi:10.1159/000333940

Cited by 44 publications

(9 citation statements)

References 7 publications

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“…In a paper from Layfield et al [38], the sensitivity in diagnosing lung tumours decreased from 100% in peripheral lesions to 82% in central lesions; however, this study was conducted in 1996 with basic CT equipment, as demonstrated by the striking differences in sensitivity between fluoroscopy guidance (97%) and CT guidance (80%). Yamagamy et al [39] demonstrated that some peripherally located lesions are not accessible at all with conventional CT guidance because of their relationship with rib arcs, thus requiring needle positioning under CT-fluoroscopy guidance.…”

Section: Diagnostic Accuracymentioning

confidence: 94%

Imaging-guided chest biopsies: techniques and clinical results

et al. 2017

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BackgroundThis article aims to comprehensively describe indications, contraindications, technical aspects, diagnostic accuracy and complications of percutaneous lung biopsy.MethodsImaging-guided biopsy currently represents one of the predominant methods for obtaining tissue specimens in patients with lung nodules; in many cases treatment protocols are based on histological information; thus, biopsy is frequently performed, when technically feasible, or in case other techniques (such as bronchoscopy with lavage) are inconclusive.ResultsAlthough a coaxial system is suitable in any case, two categories of needles can be used: fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB), with the latter demonstrated to have a slightly higher overall sensitivity, specificity and accuracy.ConclusionPercutaneous lung biopsy is a safe procedure even though a few complications are possible: pneumothorax, pulmonary haemorrhage and haemoptysis are common complications, while air embolism and seeding are rare, but potentially fatal complications.Teaching points • Imaging-guided biopsy is one of the main methods to obtain lung nodule specimens. • CT has the highest accuracy for diagnosis as an imaging guide. • Compared to FNAB, CNB has a higher accuracy for diagnosis. • Pneumothorax and parenchymal pulmonary haemorrhage care the most frequent complications. • Several clinical and technical variables can affect diagnostic accuracy and patient safety.

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Section: Diagnostic Accuracymentioning

confidence: 94%

Imaging-guided chest biopsies: techniques and clinical results

et al. 2017

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“…[1] The imaging techniques used for percutaneous transthoracic FNAC include fluoroscopy,[23] ultrasonography,[4] and computed tomography (CT). [35–7] Sonography is used for guidance in pulmonary, pleural or mediastinal lesions in contact with the chest wall and CT for those not approachable by sonography. CT has, among its advantages, clear depiction of anatomical details and access to any area of the body.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of precision of guidance techniques in image guided fine needle aspiration cytology of thoracic mass lesions

Kalhan

Sharma

et al. 2012

J Cytol

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Background:Transthoracic fine needle aspiration cytology (FNAC) is an established and safe technique for diagnosis of thoracic mass lesions. Computed tomography (CT) scan depicts clear anatomical details and provides access to any area of the body. It is, however, expensive and the needle is not passed in real time. Ultrasound is cheaper, radiation free, and allows real time monitoring. Its limitations are obscurement of lesions by aerated lung, smaller, deep seated, and cavitary lesions.Aims:This study aims to compare sensitivity and specificity of CT scan and ultrasonography (USG) in thoracic FNAC.Materials and Methods:The study was conducted on patients who presented with thoracic mass lesions in lungs, mediastinum, hilar lymph nodes, thoracic vertebrae, paraspinal soft tissue, and pleura. One hundred and twenty patients were studied. Only those cases in which sonographic guidance was not possible were taken up for CT guided FNAC. The lesions were assigned to benign and malignant categories and into specific diagnoses where possible. Biopsy correlation was available in 113 cases. Patients were lost to follow-up in five lung and two mediastinal masses.Statistical Analysis:Statistical tests applied included diagnostic tests for sensitivity and specificity.Results:An accuracy of 70.8% was found for image guided FNACs with a sensitivity and specificity of 92.2% and 100%, respectively. CT had a sensitivity of 93.2% and specificity of 100%. For USG guidance, the same was 91.3% and 100%, respectively.Conclusions:Precision of USG and CT scan is comparable for guidance in FNAC from thoracic mass lesions.

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“…Layfield et al (13) demonstrated that lesion location and size affect the diagnostic accuracy of thoracic FNAB and that the best results are obtained for peripheral and larger lesions. In the present study, lesions with diameters ≥40 mm supplied larger amounts of adequate biopsy material, thus enabling more specific diagnoses compared to smaller lesions using both biopsy techniques.…”

Section: Discussionmentioning

confidence: 99%

CT-guided biopsy of lung lesions: defining the best needle option for a specific diagnosis

Guimarães¹,

Marchiori²,

Hochhegger³

et al. 2014

Clinics

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OBJECTIVES:To evaluate the performance of fine and cutting needles in computed tomography guided-biopsy of lung lesions suspicious for malignancy and to determine which technique is the best option for a specific diagnosis.METHODS:This retrospective study reviewed the data from 362 (71.6%) patients who underwent fine-needle aspiration biopsy and from 97 (19.7%) patients who underwent cutting-needle biopsy between January 2006 and December 2011. The data concerning demographic and lesion characteristics, procedures, biopsy sample adequacy, specific diagnoses, and complications were collected. The success and complication rates of both biopsy techniques were calculated.RESULTS:Cutting-needle biopsy yielded significantly higher percentages of adequate biopsy samples and specific diagnoses than did fine-needle aspiration biopsy (p<0.05). The sensitivity, specificity, and accuracy of cutting-needle biopsy were 93.8%, 97.3%, and 95.2%, respectively; those of fine-needle aspiration biopsy were 82.6%, 81.3%, and 81.8%, respectively (all p<0.05). The incidence of pneumothorax was higher for fine-needle aspiration biopsy, and that of hematoma was higher for cutting-needle biopsy (both p<0.05).CONCLUSIONS:Our experience using these two techniques for computed tomography-guided percutaneous biopsy showed that cutting-needle biopsy yielded better results than did fine-needle aspiration biopsy and that there was no significant increase in complication rates to indicate the best option for specific diagnoses.

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Transthoracic Fine Needle Aspiration Biopsy

Cited by 44 publications

References 7 publications

Imaging-guided chest biopsies: techniques and clinical results

Imaging-guided chest biopsies: techniques and clinical results

Evaluation of precision of guidance techniques in image guided fine needle aspiration cytology of thoracic mass lesions

CT-guided biopsy of lung lesions: defining the best needle option for a specific diagnosis

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