Ultrasound-guided percutaneous needle biopsies of peripheral pulmonary lesions: diagnostic efficacy and risk factors for diagnostic failure
| Autor: | Zhi-Xian Li, Shi Tang, Xin-Hong Liao, Li Zhang, Qing Li |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Advanced and Specialized Nursing
China medicine.medical_specialty Percutaneous medicine.diagnostic_test business.industry Biopsy Needle Ultrasound Diagnostic accuracy Odds ratio Sensitivity and Specificity Confidence interval Ultrasound guided Peripheral Anesthesiology and Pain Medicine Risk Factors Biopsy medicine Humans Radiology business Ultrasonography Interventional Retrospective Studies |
| Zdroj: | Annals of Palliative Medicine. 10:9772 |
| ISSN: | 2224-5839 2224-5820 |
| DOI: | 10.21037/apm-21-2220 |
| Popis: | BACKGROUND To evaluate the diagnostic performance of ultrasound-guided percutaneous needle biopsy (US-PNB) for peripheral pulmonary lesions on the basis of the intention-to-diagnose principle and to identify the risk factors for diagnostic failure. METHODS Patients with peripheral pulmonary lesions who underwent US-PNB in the Department of Ultrasound, the First Affiliated Hospital of Guangxi Medical University, China, from January 2017 to December 2019 were retrospectively enrolled in this study. The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ultrasound-guided biopsy in peripheral pulmonary lesions was assessed. The proportion of diagnostic failure was calculated and the associated risk factors were identified. RESULTS A total of 930 patients were enrolled in this study, including 957 US-PNBs. The overall diagnostic accuracy, sensitivity, and specificity was 90.3% [864/957; 95% confidence interval (CI): 0.88-0.922], 87.2% (495/568; 95% CI: 0.84-0.90), and 94.9% (369/389; 95% CI: 0.92-0.97), respectively. The PPVs and NPVs were 99.4% (495/498; 95% CI: 0.98-0.99) and 88.1% (369/419; 95% CI: 0.85-0.91), respectively. The diagnostic failure rate was 9.72% (93/957; 95% CI: 0.08-0.12). The independent risk factors for diagnostic failure were history of smoking [odds ratio (OR) 1.78, 95% CI: 1.13-2.78], 18G biopsy needle (OR 2.97, 95% CI: 1.06-8.30), and final clinical diagnosis of malignant lesions (OR 2.72, 95% CI: 1.63-4.55). CONCLUSIONS US-PNB of peripheral pulmonary lesions show high diagnostic efficacy. A history of smoking, use of 18G biopsy needle, and final clinical diagnosis of malignant lesions are independent risk factors for diagnostic failure of US-PNB in peripheral pulmonary lesions. Identification of the independent risk factors for diagnostic failure can help reduce the diagnostic failure rate. |
| Databáze: | OpenAIRE |
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