title: Transthoracic Computed Tomography-Guided Lung Nodule Biopsy: Comparison of Core Needle and Fine Needle Aspiration Techniques.
abstract: OBJECTIVE
  To determine if there is a statistically significant difference in the computed tomography (CT)-guided trans-thoracic needle biopsy diagnostic rate, complication rate, and degree of pathologist confidence in diagnosis between core needle biopsy (CNB) and fine needle aspiration biopsy (FNAB).
  
  
  METHODS
  A retrospective cohort design was used to compare the diagnostic biopsy rate, diagnostic confidence, and biopsy-related complications of pneumothorax, chest tube placement, pulmonary hemorrhage, hemoptysis, admission to hospital, and length of stay between 251 transthoracic needle biopsies obtained via CNB (126) or FNAB (125). Complication rates were assessed using imaging and clinical follow-up. Final diagnosis was confirmed via surgical pathology or clinical follow-up over a period of up to 10 years.
  
  
  RESULTS
  CNB provided diagnostic samples in 91% and FNA in 80% of biopsies, which was statistically significant (P < .05). The sensitivities for CNB and FNAB were 89% (85 of 95) and 95% (84 of 88), respectively. The specificity of CNB was 100% (21 of 21) and for FNAB was 81% (2 of 11) with 2 false positives in the FNAB group. The differences in complication rate was not statistically significant for pneumothorax (50% vs 46%; determined by routine postbiopsy CT), chest tube (2% vs 4%), hemoptysis (4% vs 6%), and pulmonary hemorrhage (38% vs 47%) between FNAB and CNB, respectively. Seven patients requiring chest tube were admitted to hospital, 2 in the FNAB cohort for an average of 2.5 days and 5 in the CNB cohort for an average of 4.6 days.
  
  
  CONCLUSIONS
  CNB provided more diagnostic samples with no statistical difference in complication rate.
authors.affiliation: Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: bippans@gmail.com.
authors.forename: Bippan S
authors.initials: BS
authors.lastname: Sangha
authors.affiliation: Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Cameron J
authors.initials: CJ
authors.lastname: Hague
authors.affiliation: Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Jessup
authors.affiliation: Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: O'Connor
authors.affiliation: Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: John R
authors.initials: JR
authors.lastname: Mayo
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D044963:Biopsy, Fine-Needle / Q000009:adverse effects; D062005:Biopsy, Large-Core Needle / Q000009:adverse effects; D015505:Chest Tubes; D005189:False Positive Reactions; D005260:Female; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
keywords: Core needle biopsy; Fine needle aspiration biopsy; Lung nodule; Transthoracic lung nodule biopsy