title: CT guided percutaneous fine needle biopsy of small lung lesions in outpatients. Safety and efficacy of the procedure compared to inpatients.
abstract: OBJECTIVE
  To compare the safety and efficacy of CT-guided fine needle biopsy (FNAB) of small (<15 mm) lung lesions in inpatients and outpatients.
  
  
  METHODS
  108 consecutive inpatients (69 M, 39 F, mean age 56) and 121 consecutive outpatients (90 M, 31 F, mean age 50) who underwent CT-guided FNAB of small lung lesions were included. Lesion size, depth, number of needle passes, presence of emphysema were recorded. 22 G Chiba needles and the roll-over technique were used for all patients; if no significant pneumothorax was detected after FNAB, outpatients were allowed to go home and instructed to return in case of complications. The incidence of pneumothorax and other complications, sensitivity, specificity, diagnostic accuracy were calculated.
  
  
  RESULTS
  12 inpatients and 33 outpatients were lost to follow-up. No statistical differences were observed in lesion size, depth, needle passes, presence of emphysema between the groups. We had 15 pneumothoraces in inpatients, 4 requiring a chest tube, 12 in outpatients, 2 requiring a tube. Diagnostic accuracy was 92.7% in inpatients and 90.9% in outpatients. There were 7 false negatives in inpatients and 8 in outpatients, with negative predictive value of 79% and 78%, respectively. There were no false positives. All differences are nonsignificant.
  
  
  CONCLUSIONS
  CT-guided FNAB of small lung lesions is an equally safe and effective procedure in inpatients and outpatients; outpatient performance of FNAB can decrease costs.
authors.affiliation: Dipartimento Assistenziale di Radiologia e Radioterapia, Università degli Studi Federico II, Naples. maurizio_romano@hotmail.com
authors.forename: Maurizio
authors.initials: M
authors.lastname: Romano
authors.forename: Salvatore
authors.initials: S
authors.lastname: Griffo
authors.forename: Maria
authors.initials: M
authors.lastname: Gentile
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Mainenti
authors.forename: Oscar
authors.initials: O
authors.lastname: Tamburrini
authors.forename: Vittorio
authors.initials: V
authors.lastname: Iaccarino
authors.forename: Marco
authors.initials: M
authors.lastname: Salvatore
mesh_terms: D044963:Biopsy, Fine-Needle / Q000009:adverse effects; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011030:Pneumothorax / Q000209:etiology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed