Diagnostic accuracy of CT-guided core biopsy of ground-glass opacity pulmonary lesions.
OBJECTIVE
The purpose of our study was to evaluate the accuracy of CT-guided percutaneous core biopsy of ground-glass opacity (GGO) pulmonary lesions.


METHODS
The study included 50 patients (24 men, 26 women; age range, 43-78 years) who had a GGO pulmonary lesion and underwent CT-guided core biopsy. Diagnostic accuracy was compared between two groups according to lesion size (< 2 cm vs > or = 2 cm) and GGO component (> 90% vs 50-90%). Each case was reviewed for complications, including pneumothorax, thoracostomy tube insertion, and hemoptysis.


RESULTS
Malignancy was finally diagnosed in 33 patients, including three who underwent repeated biopsies, with 33 true-positive and three false-negative findings for an overall sensitivity of 92% (33/36). A benign lesion was finally diagnosed in 10 patients with one false-positive result, for a specificity of 90%. Two benign lesions without confirmative diagnosis because of loss of follow-up and five nondiagnostic samples were excluded from the calculations of sensitivity, specificity, and diagnostic accuracy. The overall diagnostic accuracy was 91%, with a positive predictive value of 97% and a negative predictive value of 75%. Sensitivity and accuracy were not significantly different between the two groups of lesion size and GGO components (p = 0.0491). Ten (18%) patients had pneumothorax, with one (2%) requiring placement of a thoracostomy tube. Mild hemoptysis occurred in seven (13%) patients.


CONCLUSIONS
CT-guided core biopsy of GGO lesions can yield high diagnostic accuracy and acceptable complication rates approaching those of solid lesions.
Kim
Tae Jung
TJ
Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Korea.
Lee
Jae-Ho
JH
Lee
Choon-Taek
CT
Jheon
Sang Hoon
SH
Sung
Sook Whan
SW
Chung
Jin-Haeng
JH
Lee
Kyung Won
KW
D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods*; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000000981:diagnostic imaging* / Q000473:pathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*