title: Combining fine-needle aspiration and core biopsy under CT fluoroscopy guidance: a better way to treat patients with lung nodules?
abstract: OBJECTIVE
  The goal of our study was to evaluate the efficacy of the combined use of fine-needle aspiration and tissue core biopsy under real-time CT fluoroscopy guidance.
  
  
  METHODS
  One hundred thirty-eight percutaneous needle lung biopsy samples were obtained by two methods. The samples obtained by tissue fine-needle aspiration underwent cytologic evaluation, and those obtained by core biopsy using an automated cutting needle underwent histologic evaluation. The final diagnosis was confirmed by independent surgical pathologic findings, independent culture results, or clinical follow-up.
  
  
  RESULTS
  Rates of adequate specimens obtained and of precise diagnosis by combined use of fine-needle aspiration and core biopsy were 97.1% (134/138) and 94.2% (130/138) evaluated lung lesions, respectively, whereas those rates were 84.8% (117/138) and 79.7% (110/138) by fine-needle aspiration alone and 91.3% (126/138) and 89.1% (123/138) by core biopsy alone, respectively. Precise diagnosis was achieved by the combined use of the techniques in 30 (93.8%) of 32 lesions ranging from 3 to 10 mm in diameter, 42 (93.3%) of 45 lesions ranging from 11 to 20 mm, 43 (93.5%) of 46 lesions ranging from 21 to 30 mm, and 100% of 15 lesions ranging from 31 to 100 mm. In 89 of 90 lesions shown to be malignant by CT-guided lung biopsy and 30 of 44 shown to be benign, specific cell types could be proven from specimens obtained by the combined use of the two different types of needle biopsy.
  
  
  CONCLUSIONS
  The combined use of fine-needle aspiration and core biopsy improves the diagnostic ability of CT fluoroscopy-guided lung biopsy, even in small lesions.
authors.affiliation: Department of Radiology, Kyoto Prefectural University of Medicine, 465 Kajii, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Yamagami
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Iida
authors.forename: Takeharu
authors.initials: T
authors.lastname: Kato
authors.forename: Osamu
authors.initials: O
authors.lastname: Tanaka
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Nishimura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed