title: Accuracy of CT-guided transthoracic needle biopsy of lung lesions: factors affecting diagnostic yield.
abstract: OBJECTIVE
  This study was performed to analyse the variables affecting the diagnostic accuracy of computed tomography (CT)-guided transthoracic needle biopsy of pulmonary lesions.
  
  
  METHODS
  A retrospective study of 612 consecutive procedures with confirmed final diagnoses was undertaken. Benign and malignant needle biopsy results were compared with final outcomes to determine diagnostic accuracy. A statistical analysis of factors related to patient characteristics, lung lesions and biopsy technique was performed to determine possible influences on diagnostic yield. A p value less than 0.05 was interpreted as statistically significant.
  
  
  RESULTS
  There were 508 (83%) malignant and 104 (17%) benign lesions. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy for a diagnosis of malignancy were 90.2%, 99.0%, 99.8%, 67.3% and 91.7%, respectively. Overall diagnostic accuracy was 83.3%. Variables affecting diagnostic accuracy were the final diagnosis (benign 67%, malignant 92%; p<0.001) and lesion size (lesions<1.5 cm 68%, lesions 1.5-5.0 cm 87%, lesions>5 cm 78%; p<0.05).
  
  
  CONCLUSIONS
  In CT-guided transthoracic needle biopsy, the final diagnosis and lesion size affect diagnostic accuracy: benign lung lesions and lesions smaller than 1.5 cm or larger than 5.0 cm in diameter provide lower diagnostic yield.
authors: Radiologia Diagnostica, Università degli Studi di Torino, A.S.O. San Luigi Gonzaga, Regione Gonzole 10, Orbassano, Turin, Italy. adriano.priola@inwind.it
authors: A M
authors: AM
authors: Priola
authors: S M
authors: SM
authors: Priola
authors: A
authors: A
authors: Cataldi
authors: L
authors: L
authors: Errico
authors: M
authors: M
authors: Di Franco
authors: P
authors: P
authors: Campisi
authors: L
authors: L
authors: Molinaro
authors: V
authors: V
authors: Marci
authors: S
authors: S
authors: Novello
authors: C
authors: C
authors: Fava
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed