Feasibility and accuracy of CT-guided percutaneous needle biopsy of cavitary pulmonary lesions
| Autor: | Nantaka Kiranantawat, Milena Petranovic, Shaunagh McDermott, Subba R. Digumarthy, Jo-Anne O. Shepard, Amita Sharma, Matthew D. Gilman |
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| Rok vydání: | 2019 |
| Předmět: |
Image-Guided Biopsy
Male Hemoptysis medicine.medical_specialty Lung Neoplasms Percutaneous medicine.medical_treatment Malignancy Sensitivity and Specificity 030218 nuclear medicine & medical imaging Lesion 03 medical and health sciences 0302 clinical medicine Chest Imaging Biopsy Site Risk Factors Biopsy Prevalence Humans Medicine Radiology Nuclear Medicine and imaging Neoplasm Metastasis Thoracic Wall Lung Aged Retrospective Studies Hemothorax medicine.diagnostic_test business.industry Biopsy Needle Pneumothorax Middle Aged medicine.disease Chest tube medicine.anatomical_structure Chest Tubes Feasibility Studies Multiple Pulmonary Nodules Female Radiology medicine.symptom Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business |
| Zdroj: | Diagnostic and Interventional Radiology. 25:435-441 |
| ISSN: | 1305-3612 |
| Popis: | Purpose We aimed to evaluate the feasibility, accuracy, and complications of computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) of cavitary lesions. Methods Consecutive PTNB procedures in an academic institution over a 4-year period were reviewed, 53 of which were performed on patients with cavitary lesions. The demographic data of patients, lesion characteristics, biopsy technique and complications, initial pathologic results, and final diagnosis were reviewed. A final diagnosis was established through surgical correlation, microbiology or clinico-radiologic follow-up for at least 18 months after biopsy. Results The overall accuracy of PTNB was 81%. In 33 patients (62%) the cavitary lesion was found to be malignant (23 lung cancers and 10 metastases). The sensitivity and specificity for malignancy was 91% and 100%, respectively. In 20 patients (38%) a benign etiology was established (16 infections and 4 noninfectious etiologies), with PTNB demonstrating a sensitivity of 81% and specificity of 100% for infection. Wall thickness at the biopsy site, lesion in lower lobe, and malignancy were significant independent risk factors for diagnostic success. Minor complications occurred in 28% of cases: 13 pneumothoraces (5 requiring chest tube), 1 small hemothorax, and 1 mild hemoptysis. A nonsignificant higher chest tube insertion rate was seen in cavities with a thinner wall. Conclusion PTNB of cavitary lesions provides high accuracy, sensitivity, and specificity for both malignancy and infection and has an acceptable complication rate. Wall thickness at the biopsy site, lesion in lower lobe, and malignancy were significant independent risk factors for diagnostic success. Samples for microbiology should be obtained in all patients, especially in the absence of on-site cytology, due to the high prevalence of infection in cavitary lesions. |
| Databáze: | OpenAIRE |
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