title: CT-guided transthoracic needle aspiration biopsy of subsolid lung lesions.
abstract: OBJECTIVE
  To assess the diagnostic performance of computed tomography (CT)-guided transthoracic needle aspiration biopsy (TNAB) in the evaluation of persistent subsolid lung lesions.
  
  
  METHODS
  A retrospective review of all CT-guided TNABs performed at a single institution from January 2002 to November 2012 was conducted to identify patients with persistent subsolid lung lesions. The diagnostic performance of CT-guided TNAB was assessed through comparison of cytologic diagnoses with core needle biopsy, surgical resection, or imaging and clinical follow-up. The cytologic, histologic, and imaging features of each lesion were characterized, and CT-guided TNAB complications were recorded.
  
  
  RESULTS
  In 32 patients, a diagnosis of benign or malignant disease was identified through evaluation of pathologic or follow-up data. There were 18 men and 14 women, with a mean age of 67.1 years ± 9.6 (range, 52-86 y). The mean lesion diameter was 21 mm ± 11 (range, 8-62 mm). A final diagnosis of malignancy was made in 28 cases (87.5%); four benign lesions were also diagnosed. The overall sensitivity of CT-guided TNAB in the evaluation of these lesions was 89.2%, and the specificity and positive predictive value were 100%. Two pneumothoraces (6.3%) were identified.
  
  
  CONCLUSIONS
  Among patients with subsolid lung lesions, CT-guided TNAB is safe and shows high sensitivity. The high specificity and positive predictive value of the procedure allow for definitive treatment decisions to be made for most patients.
authors.affiliation: Department of Radiology, The University of Vermont College of Medicine, Fletcher Allen Health Care, 111 Colchester Avenue, Burlington, VT 05401.
authors.forename: Aaron W P
authors.initials: AW
authors.lastname: Maxwell
authors.affiliation: Department of Radiology, Fletcher Allen Health Care, 111 Colchester Avenue, Burlington, VT 05401. Electronic address: jsklein@uvm.edu.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Klein
authors.affiliation: Department of Pathology, Fletcher Allen Health Care, 111 Colchester Avenue, Burlington, VT 05401.
authors.forename: Kossivi
authors.initials: K
authors.lastname: Dantey
authors.affiliation: Department of Pathology, Fletcher Allen Health Care, 111 Colchester Avenue, Burlington, VT 05401.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Mount
authors.affiliation: Department of Pathology, Fletcher Allen Health Care, 111 Colchester Avenue, Burlington, VT 05401.
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Butnor
authors.affiliation: Department of Pathology, Fletcher Allen Health Care, 111 Colchester Avenue, Burlington, VT 05401.
authors.forename: Gladwyn
authors.initials: G
authors.lastname: Leiman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*