title: Percutaneous CT-guided aspiration and core biopsy of pulmonary nodules smaller than 1 cm: analysis of outcomes of 305 procedures from a tertiary referral center.
abstract: OBJECTIVE
  We conducted a retrospective analysis to evaluate the diagnostic outcomes of CT-guided aspiration and core biopsy of 305 pulmonary nodules measuring less than 1 cm.
  
  
  METHODS
  We determined the diagnostic yield of using CT-guided aspiration and core biopsy to analyze 305 lesions in 290 patients. Diagnostic performance was evaluated according to the biopsy method, including aspiration alone, core biopsy alone, and combination use, and the consistency of the nodule, including solid, partly solid ground-glass opacity (GGO), and pure GGO. Final diagnoses were established in 268 of the 305 lesions (87.9%). Nondiagnostic biopsy results were obtained for 27 of the 268 lesions (10.1%).
  
  
  RESULTS
  The overall sensitivity, specificity, positive predictive value, and negative predictive value for the diagnosis of malignancy were 93.1% (148 of 159 lesions), 98.8% (81/82), 99.3% (148/149), and 88.0% (81/92), respectively; diagnostic accuracy was 95.0% (229/241). Using multivariate logistic regression analysis, we found that aspiration alone was a significant independent risk factor associated with diagnostic failure (odds ratio, 3.199; p = 0.001).
  
  
  CONCLUSIONS
  The use of CT-guided aspiration and core biopsy resulted in a high diagnostic yield for pulmonary nodules smaller than 1 cm. The use of the aspiration method alone was an independent risk factor associated with diagnostic failure.
authors.affiliation: 1 All authors: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 138-736, Korea.
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Choi
authors.forename: Eun Jin
authors.initials: EJ
authors.lastname: Chae
authors.forename: Ji-Eun
authors.initials: JE
authors.lastname: Kim
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Kim
authors.forename: Sang Young
authors.initials: SY
authors.lastname: Oh
authors.forename: Hye Jeon
authors.initials: HJ
authors.lastname: Hwang
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D062005:Biopsy, Large-Core Needle; D001707:Biopsy, Needle; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015641:Radiography, Interventional / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*