Additional value of CT-fluoroscopic biopsy of pulmonary lesions: a retrospective study of 69 patients.
The purpose of this retrospective study was to evaluate the diagnostic accuracy of CT-fluoroscopic transthoracic biopsy of pulmonary lesions related to their localization and size. The complication rate was also evaluated. Between January 2003 and June 2004, we performed seventy-two CT-fluoroscopic transthoracic biopsies in sixty-nine patients. Lesions were subdivided in subpleural, peripheral and central lesions. The lesions were also subdivided concerning their diameter. Fifty three lesions (77%) had a final diagnosis of malignancy and 13 lesions (19%) had a final benign diagnosis. CT-fluoroscopic transthoracic biopsy had an overall diagnostic accuracy of 84.4%, sensitivity of 80.7%, specificity of 100%, positive predictive value of 100% and negative predictive value of 54.5%. For lesions between 1 and 3 cm the accuracy was 78.5% for lesions greater than 3 cm 87%. Only one lesion was smaller than 1 cm, this lesion was true positive. There were no false-positive findings. Pneumothoraces were observed in only 7 patients (10%) and there was only 1 small postpuncture hemothorax (1.7%). CT-fluoroscopic biopsy of pulmonary lesions has a good diagnostic accuracy with a very low complication rate. The accuracy is higher for larger lesions, but there is no significant difference for subpleural and peripheral lesions.
Bladt
O
O
Department of Radiology, UZ Gasthuisberg, Leuven , Belgium.
De Wever
W
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods*; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000473:pathology; D002648:Child; D005188:False Negative Reactions; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D005500:Follow-Up Studies; D006491:Hemothorax / Q000209:etiology; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000000981:diagnostic imaging / Q000473:pathology; D011030:Pneumothorax / Q000209:etiology; D011237:Predictive Value of Tests; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*