title: Computed tomography-guided percutaneous needle biopsy of pulmonary nodules: impact of nodule size on diagnostic accuracy.
abstract: OBJECTIVE
  This study was undertaken to compare the diagnostic accuracy and complication rate of computed tomography (CT)-guided percutaneous lung biopsies of lung nodules<or=1.5 cm versus >1.5 cm in diameter.
  
  
  METHODS
  A total of 139 patients (age range, 18-89 years; mean, 62.5 years) underwent CT-guided percutaneous fine-needle aspiration biopsy or 20-gauge core biopsy using an automated biopsy gun. In 37 patients, the lung nodule measured <or=1.5 cm (mean, 1.1 cm), and in 102 patients, the lung nodule was >1.5 cm (mean, 2.8 cm). Diagnostic accuracy was determined by cytopathology results. Major and minor complications were documented.
  
  
  RESULTS
  Overall diagnostic accuracy, pneumothorax rate, and thoracostomy tube insertion rates were 67.6%, 34.5%, and 5%, respectively. Of the 98 patients with malignancy, 77 patients (78.6%) had a definite diagnostic biopsy. Overall, nodules>1.5 cm were statistically more likely to result in a diagnostic specimen (73.5%) than nodules<or=1.5 cm (51.4%; P=.012). Similarly, diagnostic accuracy for malignancy was higher in nodules>1.5 cm than in those<or=1.5 cm (81.3% vs. 69.6%); however, this was not statistically significant. There was no correlation between nodule size and the incidence of complications.
  
  
  CONCLUSIONS
  Overall, diagnostic accuracy of CT-guided percutaneous lung biopsy of lung nodules<or=1.5 cm is slightly lower than that of nodules>1.5 cm. However, the diagnostic accuracy for malignancy is high in both groups, with a low risk of complications.
authors.affiliation: Department of Interventional Radiology, Stanford University Medical Center, Stanford, CA 94305, USA. kothary@stanford.edu
authors.forename: Nishita
authors.initials: N
authors.lastname: Kothary
authors.forename: Laura
authors.initials: L
authors.lastname: Lock
authors.forename: Daniel Y
authors.initials: DY
authors.lastname: Sze
authors.forename: Lawrence V
authors.initials: LV
authors.lastname: Hofmann
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000009:adverse effects / Q000592:standards*; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology; D015203:Reproducibility of Results; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden