title: CT-guided core needle biopsy of pleural lesions: evaluating diagnostic yield and associated complications.
abstract: OBJECTIVE
  The purpose of this study was to retrospectively evaluate the diagnostic accuracy and complications of CT-guided core needle biopsy (CT-guided CNB) of pleural lesion and the possible effects of influencing factors.
  
  
  METHODS
  From September 2007 to June 2013, 88 consecutive patients (60 men and 28 women; mean [± standard deviation] age, 51.1 ± 14.4 years; range, 19-78 years) underwent CT-guided CNB, which was performed by two experienced chest radiologists in our medical center. Out of 88 cases, 56 (63%) were diagnosed as malignant, 28 (31%) as benign and 4 (5%) as indeterminate for CNB of pleural lesions. The final diagnosis was confirmed by either histopathological diagnosis or clinical follow-up. The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and complication rates were statistically evaluated. Influencing factors (patient age, sex, lesion size, pleural-puncture angle, patient position, pleural effusion, and number of pleural punctures) were assessed for their effect on accuracy of CT-guided CNB using univariate and subsequent multivariate analysis.
  
  
  RESULTS
  Diagnostic accuracy, sensitivity, specificity, PPV, and NPV were 89.2%, 86.1%, 100%, 100%, and 67.8%, respectively. The influencing factors had no significant effect in altering diagnostic accuracy. As far as complications were concerned, occurrence of pneumothorax was observed in 14 (16%) out of 88 patients. Multivariate analysis revealed lesion size/pleural thickening as a significant risk factor (odds ratio [OR]: 8.744, p = 0.005) for occurrence of pneumothorax. Moreover, presence of pleural effusion was noted as a significant protective factor (OR: 0.171, p = 0.037) for pneumothorax.
  
  
  CONCLUSIONS
  CT-guided CNB of pleural lesion is a safe procedure with high diagnostic yield and low risk of significant complications.
authors.affiliation: Department of Radiology, Affiliated Hospital of Chengdu University, Chengdu, Sichuan Province 610000, China.
authors.forename: Xiang-Ke
authors.initials: XK
authors.lastname: Niu
authors.affiliation: Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province 637000, China.
authors.forename: Anup
authors.initials: A
authors.lastname: Bhetuwal
authors.affiliation: Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province 637000, China.
authors.forename: Han-Feng
authors.initials: HF
authors.lastname: Yang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D062005:Biopsy, Large-Core Needle / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010996:Pleural Effusion / Q000175:diagnosis* / Q000473:pathology; D011030:Pneumothorax / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: CT-guided core needle biopsy; Complication; Pleural biopsy