title: Diagnostic accuracy of CT fluoroscopy-guided needle aspiration biopsy of ground-glass opacity pulmonary lesions.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the diagnostic performance of CT fluoroscopy-guided percutaneous needle aspiration biopsy of ground-glass opacity (GGO) pulmonary lesions.
  
  
  METHODS
  Twenty-eight patients with GGO lesions who underwent CT fluoroscopy-guided needle aspiration biopsy were enrolled in this study. GGO lesions were divided into three groups according to their size: group 1, lesions < or = 10 mm (n = 10); group 2, lesions 11-20 mm (n = 10); and group 3, lesions > 20 mm (n = 8). Sensitivity, specificity, and diagnostic accuracy were calculated on the basis of 28 needle aspiration biopsy results and were compared among the three groups using Fisher's exact test. Diagnostic accuracy was also compared according to length of needle path (< 5 cm vs 5-9 cm vs > 9 cm) and GGO component (50-90% vs > 90%). Each case was reviewed for complications, which included pneumothorax, thoracostomy tube insertion, and hemoptysis.
  
  
  RESULTS
  There were 17 (61%) malignant and 11 (39%) benign lesions. Three (10%) biopsy results were nondiagnostic, all of which were confirmed as benign. The sensitivity, specificity, and accuracy of CT fluoroscopy-guided needle aspiration biopsy for diagnosing GGO were 67%, 100%, and 80% in group 1; 71%, 100%, and 80% in group 2; and 75%, 100%, and 88% in group 3. The diagnostic accuracy of CT fluoroscopy-guided needle aspiration biopsy for diagnosing GGO was not significantly different among the three groups (p > 0.05). The diagnostic accuracy was not significantly different according to the length of the needle path (p > 0.05). However, diagnostic accuracy was significantly more accurate in mixed GGO lesions than in pure GGO lesions (p = 0.046). Five patients (18%) developed a pneumothorax, two of whom (7%) required placement of a thoracostomy tube. Mild hemoptysis occurred in three patients (11%).
  
  
  CONCLUSIONS
  CT fluoroscopy-guided needle aspiration biopsy is a useful diagnostic technique for GGO pulmonary lesions and has an acceptable complication rate, even for small and deeply located lesions. The diagnostic accuracy is influenced by the GGO component.
authors.affiliation: Department of Diagnostic Radiology, Severance Hospital, Yonsei University College of Medicine, 250 Seongsanno (134 Sinchon-dong), Seodaemun-gu, Seoul 120-752, South Korea.
authors.forename: Jin
authors.initials: J
authors.lastname: Hur
authors.forename: Hye-Jeong
authors.initials: HJ
authors.lastname: Lee
authors.forename: Ji Eun
authors.initials: JE
authors.lastname: Nam
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Kim
authors.forename: Kyu Ok
authors.initials: KO
authors.lastname: Choe
authors.forename: Byoung Wook
authors.initials: BW
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001707:Biopsy, Needle / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015641:Radiography, Interventional / Q000379:methods*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*