title: CT-guided percutaneous cutting needle biopsy of thymic epithelial tumors comparison to the accuracy of computed tomographic diagnosis according to the world health organization classification.
abstract: OBJECTIVE
  The aims of this study were to compare diagnostic accuracy between computed tomography (CT)-guided percutaneous cutting needle biopsy (PCNB) and surgery or open biopsy for thymic epithelial tumors in accordance with the World Health Organization (WHO) classification and to evaluate computed tomographic diagnosis additionally.
  
  
  METHODS
  Subjects were 20 patients (11 men, 9 women) in whom CT, CT-guided PCNB, and surgery had been performed for anterior mediastinal tumors. All diagnoses of both CT-guided PCNB and surgery or open biopsy were made in accordance with the WHO classification. Computed tomographic diagnoses were performed by two radiologists on the basis of radiologic characteristics previously reported according to the simplified WHO classification (types A and AB, type B1, types B2 and B3, and thymic carcinoma). The concordance of the WHO classification or the simplified WHO classification between the diagnosis on either CT or CT-guided PCNB and that on surgery was evaluated using the weighted kappa statistic.
  
  
  RESULTS
  The histologic classifications on the basis of surgical resection specimens were as follows: type A, n = 3; type AB, n = 5; type B1, n = 3; type B2, n = 4; type B3, n = 4; and thymic carcinoma, n = 1. The overall concordance with the diagnosis according to the WHO classification established using CT-guided PCNB specimens (weighted kappa = 0.757) was higher than that using computed tomographic diagnosis (weighted kappa = 0.437).
  
  
  CONCLUSIONS
  CT-guided PCNB is a technique with good concordance of the WHO classification of thymic epithelial tumors between the diagnoses of surgery or open biopsy.
authors.affiliation: Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan. m-yanagawa@radiol.med.osaka-u.ac.jp
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yanagawa
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Tomiyama
authors.forename: Osamu
authors.initials: O
authors.lastname: Honda
authors.forename: Ayano
authors.initials: A
authors.lastname: Kikuyama
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Sumikawa
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Koyama
authors.forename: Atsuo
authors.initials: A
authors.lastname: Inoue
authors.forename: Takeshi
authors.initials: T
authors.lastname: Johkoh
authors.forename: Meinoshin
authors.initials: M
authors.lastname: Okumura
authors.forename: Eiichi
authors.initials: E
authors.lastname: Morii
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013953:Thymus Neoplasms / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014944:World Health Organization