Negative predictive value of imaging-guided abdominal biopsy results: cytologic classification and implications for patient management.
OBJECTIVE
Our purpose was to assess the negative predictive value of imaging-guided abdominal biopsy results and correlate it with cytology classification, lesion size, needle gauge, and cancer history.


METHODS
A retrospective study was performed of 100 patients with proven diagnoses who had undergone imaging-guided abdominal biopsies showing no cells that were malignant or suspicious for malignancy. Specimens were classified as normal or benign, nondiagnostic, or atypical. Negative predictive value was calculated for each cytologic category, lesion size, needle gauge, and cancer history. Logistic regression analysis was performed to allow us to identify predictors of false-negative results.


RESULTS
Overall negative predictive value was 67%. Other negative predictive values were normal or benign result, 78%; nondiagnostic result, 66%; and atypical result, 29%. Negative predictive value was greater when the lesion was large (> or =3 cm) (p = .031). Logistic regression analysis allowed us to predict a 9.3% chance of a false-negative result for a specimen of normal or benign cytology that was taken from a large lesion in a patient with no cancer history but an 87% chance of a false-negative when a specimen of atypical cytology was taken from a small (<3 cm) lesion in a patient with a cancer history.


CONCLUSIONS
Imaging-guided abdominal biopsy specimens containing atypical cells should be viewed with caution. In patients without cancer, if a lesion is large and the specimen contains normal target organ or benign cells, the likelihood of a false-negative result may be low enough that imaging surveillance at appropriate intervals may be sufficient.
Phillips
M D
MD
Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA.
Silverman
S G
SG
Cibas
E S
ES
Seltzer
S E
SE
D000008:Abdominal Neoplasms / Q000453:epidemiology / Q000473:pathology*; D001707:Biopsy, Needle / Q000379:methods* / Q000706:statistics & numerical data; D015331:Cohort Studies; D003952:Diagnostic Imaging; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009339:Needles; D011237:Predictive Value of Tests; D015641:Radiography, Interventional; D012189:Retrospective Studies