Accuracy of CT-guided transthoracic needle biopsy of lung lesions: factors affecting diagnostic yield.
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.
Priola
A M
AM
Radiologia Diagnostica, Università degli Studi di Torino, A.S.O. San Luigi Gonzaga, Regione Gonzole 10, Orbassano, Turin, Italy. adriano.priola@inwind.it
Priola
S M
SM
Cataldi
A
A
Errico
L
L
Di Franco
M
M
Campisi
P
P
Molinaro
L
L
Marci
V
V
Novello
S
S
Fava
C
C
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