title: Computed tomography-guided transthoracic fine-needle aspiration in diagnosis of lung cancer: a comparison of single-pass needle and multiple-pass coaxial needle systems and the value of immediate cytological assessment.
abstract: OBJECTIVE
  The aim of the present study was to compare single-pass needle and multiple-pass coaxial needle systems and to evaluate the value of immediate cytological assessment during the procedure in the diagnosis of lung cancer with CT-guided transthoracic fine-needle aspiration.
  
  
  METHODS
  One hundred and forty-three consecutive patients who underwent CT-guided transthoracic fine-needle aspiration were divided into three groups. In the first group (group A, 48 patients), a single-pass needle was used for aspiration, but immediate cytological examination was not performed. In the second group (group B, 48 patients), a single-pass needle was used for aspiration and a pathologist immediately assessed the adequacy of the sample obtained. In the third group (group C, 47 patients), a multiple-pass coaxial needle was used for aspiration and a pathologist immediately assessed the adequacy of the sample obtained.
  
  
  RESULTS
  The mean number of fine-needle aspirations was 1.25 in group A, 1.39 in group B and 1.34 in group C (group A vs group B, P = 0.08). The diagnostic accuracy was 83.3, 97.9 and 100.0%, respectively (group A vs group B, P = 0.03; group B vs group C, P > 0.05). Although immediate cytological assessment resulted in adequate samples being obtained from all patients in groups B and C, adequate samples were obtained in 41 of 48 patients (85.4%) in group A (P = 0.004). There was no statistically significant difference among the groups with respect to the rate of pneumothorax.
  
  
  CONCLUSIONS
  A single-pass needle technique in transthoracic fine-needle aspiration is preferred because there is no significant difference between single-pass needle and multiple-pass coaxial needle systems with respect to the diagnostic accuracy and the complication rate and, in addition, the single-pass needle has a lower cost. The results of the present study suggest that immediate cytological assessment during the procedure reduces an inadequate sampling rate, thus increasing the diagnostic accuracy of the procedure.
authors.affiliation: Pulmonology Department, SSK Sureyyapasa Center for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Cağla Uyanusta
authors.initials: CU
authors.lastname: Küçük
authors.forename: Adnan
authors.initials: A
authors.lastname: Yilmaz
authors.forename: Aynur
authors.initials: A
authors.lastname: Yilmaz
authors.forename: Esen
authors.initials: E
authors.lastname: Akkaya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009339:Needles; D014057:Tomography, X-Ray Computed