title: Diagnostic Yield and Safety of Computed Tomography-guided Mediastinal Core Needle Biopsies.
abstract: OBJECTIVE
  Mediastinal masses of various origins can be encountered on imaging in symptomatic or asymptomatic patients. We aimed to evaluate the diagnostic yield and complication rate of computed tomography (CT)-guided mediastinal core needle biopsies in a large population of patients presenting with mediastinal masses and to identify the factors that could influence these results.
  
  
  METHODS
  In total, 293 consecutive CT-guided mediastinal biopsies, performed in 285 patients with equivocal masses at a single center from 2006 to 2011, were included. Lesion characteristics, technical biopsy parameters, final diagnoses, diagnostic yields (number of biopsies that yielded a complete diagnosis divided by the total number of biopsies), and complication rates were recorded.
  
  
  RESULTS
  Malignant diagnoses, including lymphoproliferative disorders (N=151, 53%) and lung cancers (N=54, 19%), were established in 233 cases (82%). Benign lesions were found in 52 procedures (18%), including sarcoidosis (N=19, 7%) and infections (N=17, 6%). The overall diagnostic yield was 87% and was lower for lymphoma residual masses (57%) than for initial diagnosis or relapses of known disease (90%). Complications occurred in 21 patients (7%), but only 2 patients (0.7%) required hospitalization for >12 hours. Neither the diagnostic yield nor the complication rate was influenced by the target characteristics or by technical parameters.
  
  
  CONCLUSIONS
  CT-guided core needle biopsy of equivocal mediastinal masses is a minimally invasive procedure that is effective and safe, even in cases of small targets or targets in challenging locations.
authors.affiliation: Departments of *Radiology †Hematology ‡Pulmonology §Pathology, Hôpital Saint Louis, Paris, France.
authors.forename: Constance
authors.initials: C
authors.lastname: de Margerie-Mellon
authors.forename: Cédric
authors.initials: C
authors.lastname: de Bazelaire
authors.forename: Sandy
authors.initials: S
authors.lastname: Amorim
authors.forename: Pauline
authors.initials: P
authors.lastname: Brice
authors.forename: Abdellatif
authors.initials: A
authors.lastname: Tazi
authors.forename: Josette
authors.initials: J
authors.lastname: Brière
authors.forename: Jacques
authors.initials: J
authors.lastname: Frija
authors.forename: Eric
authors.initials: E
authors.lastname: de Kerviler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D062005:Biopsy, Large-Core Needle / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000175:diagnosis*; D008482:Mediastinum / Q000473:pathology*; D008875:Middle Aged; D061214:Patient Safety; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*