Diffuse pleural thickening: percutaneous CT-guided cutting needle biopsy.
OBJECTIVE
To assess the diagnostic yield of computed tomography (CT)-guided percutaneous cutting needle biopsy of diffuse pleural thickening.


METHODS
In 42 consecutive adult patients with diffuse pleural disease seen, 45 CT-guided percutaneous biopsies were performed with an 18-gauge cutting needle powered by a hand-held, spring-operated biopsy instrument. Results were assessed retrospectively.


RESULTS
Sufficient pleural tissue for histologic diagnosis was obtained in 42 of the 45 biopsies, with a correct histologic diagnosis made in 39 of the 42 specimens. Specificity and sensitivity for helping differentiate malignant from benign disease were 100% and 83%, respectively. Positive and negative predictive values were 1.0 and 0.60, respectively. By combining findings at biopsy and at CT (presence or absence of pleural thickness greater than 1 cm, mediastinal-circumferential involvement, irregular contour), sensitivity and negative predictive values reached 100% and 1.0, respectively.


CONCLUSIONS
Combined findings of CT-guided percutaneous cutting needle biopsy and CT are useful in first-line investigation of diffuse pleural thickening.
Scott
E M
EM
Department of Radiology, Addenbrooke's Hospital, Cambridge, England.
Marshall
T J
TJ
Flower
C D
CD
Stewart
S
S
D000230:Adenocarcinoma / Q000175:diagnosis*; D001707:Biopsy, Needle / Q000379:methods; D005260:Female; D005355:Fibrosis; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis*; D008875:Middle Aged; D010994:Pleura / Q000473:pathology*; D010997:Pleural Neoplasms / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed