CT-guided lung biopsy: factors influencing diagnostic yield and complication rate.
OBJECTIVE
To determine factors influencing diagnostic yield in computed tomography (CT)-guided biopsy of lung lesions.


METHODS
One hundred and ninety-five consecutive CT-guided lung biopsies were performed in 182 patients between August 1995 and September 2000 and either fine-needle aspirate samples for cytology or core biopsy samples for histology were collected. Procedures were divided into a diagnostic group (true-positive and true-negative results) and a non-diagnostic group (false-positive and false-negative results) and the factors affecting diagnostic accuracy assessed.


RESULTS
One hundred and fifty-six lesions (86%) were malignant, and 26 (14%) were benign. More than one biopsy was performed for 12 lesions. One hundred and thirty-two biopsies were true-positive, 27 true-negative and 36 false-negative. No false-positive results occurred in the study. Overall diagnostic accuracy was 81.5%. Significantly more core biopsies than fine-needle aspirates were diagnostic: 93 versus 78% (p<0.005). No difference was found in frequency of pneumothorax between these two groups. There was a difference in the average depth from the pleural surface of lesions in the diagnostic and non-diagnostic groups, but this did not attain statistical significance: 9.8 versus 17.2 mm (p=0.054).


CONCLUSIONS
In this study CT-guided lung biopsy core biopsy was a more accurate method of tissue sampling than fine-needle aspiration, and was not associated with an excess of complications.
Anderson
J M
JM
Department of Radiology, The Royal Infirmary of Edinburgh, Edinburgh, UK. judithanderson20@hotmail.com
Murchison
J
J
Patel
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000009:adverse effects / Q000592:standards; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology; D015641:Radiography, Interventional; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards