title: Computed tomographic fluoroscopy-guided needle aspiration biopsy as a second biopsy technique after indeterminate transbronchial biopsy results for pulmonary lesions: comparison with second transbronchial biopsy.
abstract: OBJECTIVE
  The purpose of this study was to compare the diagnostic performance of computed tomographic (CT) fluoroscopy-guided percutaneous transthoracic needle aspiration biopsy (NAB) and transbronchial lung biopsy (TBLB) after indeterminate bronchoscopy in patients with suspected malignant pulmonary lesions.
  
  
  METHODS
  We included 77 patients who underwent CTF-NAB (n = 53) or TBLB (n = 24) as a second biopsy for pulmonary lesions because of inconclusive pathologic results on initial TBLB. Sensitivity, specificity, and diagnostic accuracy were calculated and compared between the 2 groups using the Fisher exact test. Sensitivity and diagnostic accuracy were also compared according to lesion depth (central vs peripheral), lesion location (upper vs lower), and lesion size (<2 vs 2-3 vs >3 cm).
  
  
  RESULTS
  There were 50 (65%) malignant and 27 (35%) benign lesions. The overall sensitivity, specificity, and accuracy for diagnosing pulmonary lesions were 84%, 100%, and 91% for NAB and 50%, 100%, and 63% for TBLB. The sensitivity and accuracy for diagnosing pulmonary lesions were significantly different between the 2 groups (P = 0.019, and P = 0.008). The sensitivity and accuracy of TBLB for diagnosing lesions was significantly different according to the lesion size (P = 0.025, and P = 0.048).
  
  
  CONCLUSIONS
  A second biopsy using CT fluoroscopy-guided NAB is a useful diagnostic modality for exact diagnosis of pulmonary lesions in cases of inconclusive pathologic results on initial TBLB.
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Jin
authors.initials: J
authors.lastname: Hur
authors.forename: Hye-Jeong
authors.initials: HJ
authors.lastname: Lee
authors.forename: Min Kwang
authors.initials: MK
authors.lastname: Byun
authors.forename: Ji Eun
authors.initials: JE
authors.lastname: Nam
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Moon
authors.forename: Hua Sun
authors.initials: HS
authors.lastname: Kim
authors.forename: Young Jin
authors.initials: YJ
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; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed