title: Diagnostic performance of percutaneous core needle lung biopsy under multi-CT fluoroscopic guidance for ground-glass opacity pulmonary lesions.
abstract: OBJECTIVE
  The diagnostic performance of percutaneous core needle lung biopsy under multi-CT fluoroscopic guidance for ground-glass opacity (GGO) pulmonary lesions was evaluated.
  
  
  METHODS
  Out of 90 patients who underwent CT fluoroscopy-guided core needle biopsy of GGO lesions at our institution, the biopsy results and the final diagnoses were retrospectively compared in 67 patients with available data (one lesion per patient). Diagnostic performance was also compared according to the lesion size (≤ 10 mm (n=8) versus 11-20mm (n=42) versus >20mm (n=17)), the percentage of GGO component (50-90% (n=31) versus >90% (n=36)), and the length of needle path (≤ 7 cm (n=45) versus > 7 cm (n=22)). Finally, all 90 cases were reviewed for complications.
  
  
  RESULTS
  The overall sensitivity, specificity, and accuracy were 97%, 100%, and 97%, respectively. The diagnostic sensitivity and accuracy tended to be lower in smaller lesions (≤ 10 mm; 86 and 88%, 11-20mm; 97 and 98%, >20mm; 100 and 100%, respectively, p>0.05), and in lesions with lower percentage of GGO component (50-90%; 93 and 94%, >90%; 100 and 100%, respectively, p=0.21), but statistical significances were not reached. The sensitivity and accuracy were not significantly affected by the length of needle path (≤ 7 cm; 98 and 98%, > 7 cm; 95 and 96%, respectively, p=1.00). Fourteen patients (16%) developed pneumothoraces, and 13 patients (14%) experienced mild hemoptysis, all of which resolved conservatively.
  
  
  CONCLUSIONS
  The diagnostic performance was satisfactory, and it was considered that the procedure was appropriate for GGO lesions regardless of lesion size, the percentage of GGO component, or the length of needle path. The procedure was also feasible without any major complications.
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, Japan.
authors.forename: Yoshikane
authors.initials: Y
authors.lastname: Yamauchi
authors.forename: Yotaro
authors.initials: Y
authors.lastname: Izumi
authors.forename: Seishi
authors.initials: S
authors.lastname: Nakatsuka
authors.forename: Masanori
authors.initials: M
authors.lastname: Inoue
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Makio
authors.initials: M
authors.lastname: Mukai
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nomori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*