title: Diagnostic Accuracy and Safety of CT-Guided Percutaneous Transthoracic Needle Biopsies: 14-Gauge versus 22-Gauge Needles.
abstract: OBJECTIVE
  To compare the diagnostic accuracy and safety of a 14-gauge core needle versus a 22-gauge fine needle in the evaluation of thoracic lesions by CT-guided percutaneous transthoracic needle biopsy (TTNB).
  
  
  METHODS
  Medical charts of all patients who underwent CT-guided percutaneous transthoracic core-needle biopsies (CNBs) with a 14-gauge Spirotome device (99 patients, 102 procedures) and fine-needle biopsies (FNBs) with a 22-gauge Rotex needle (92 patients, 102 procedures) between 2007 and 2013 at a single academic institution were retrospectively reviewed. Variables that could influence diagnostic accuracy and safety were collected.
  
  
  RESULTS
  The overall and cancer-specific diagnostic accuracy rates were 90% and 94%, respectively, with CNB, versus 82% and 89% with FNB. Precise cancer type/subtype was provided by 97% of CNBs versus 65% of FNBs (P < .001). In patients with lung cancer considered for targeted therapy, biomarker analyses were feasible in 80% of CNBs versus 0% of FNBs (P < .001). The rate of pneumothorax was significantly higher with CNB versus FNB (31% vs 19%; P = .004), but chest tube insertion rates were similar (10% vs 11%, respectively). Major bleeding complications occurred in 1% of CNBs versus 2% of FNBs and were associated with one death in the CNB group.
  
  
  CONCLUSIONS
  Percutaneous transthoracic CNB with a 14-gauge Spirotome needle provided better characterization of cancer lesions and allowed biomarker analyses without a significant increase in major procedural complications.
authors.affiliation: Division of Pulmonology, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain Namur, Avenue G. Thérasse, 1, B5530 Yvoir, Belgium. Electronic address: sebahat.ocak@uclouvain.be.
authors.forename: Sebahat
authors.initials: S
authors.lastname: Ocak
authors.affiliation: Division of Pulmonology, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain Namur, Avenue G. Thérasse, 1, B5530 Yvoir, Belgium.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Duplaquet
authors.affiliation: Scientific Support Unit, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain Namur, Avenue G. Thérasse, 1, B5530 Yvoir, Belgium.
authors.forename: Jacques
authors.initials: J
authors.lastname: Jamart
authors.affiliation: Division of Pulmonology, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain Namur, Avenue G. Thérasse, 1, B5530 Yvoir, Belgium.
authors.forename: Lionel
authors.initials: L
authors.lastname: Pirard
authors.affiliation: Department of Pathology, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain Namur, Avenue G. Thérasse, 1, B5530 Yvoir, Belgium.
authors.forename: Birgit
authors.initials: B
authors.lastname: Weynand
authors.affiliation: Department of Pathology, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain Namur, Avenue G. Thérasse, 1, B5530 Yvoir, Belgium.
authors.forename: Monique
authors.initials: M
authors.lastname: Delos
authors.affiliation: Division of Cardio-Vascular and Thoracic Surgery, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain Namur, Avenue G. Thérasse, 1, B5530 Yvoir, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Eucher
authors.affiliation: Division of Cardio-Vascular and Thoracic Surgery, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain Namur, Avenue G. Thérasse, 1, B5530 Yvoir, Belgium.
authors.forename: Benoît
authors.initials: B
authors.lastname: Rondelet
authors.affiliation: Department of Radiology, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain Namur, Avenue G. Thérasse, 1, B5530 Yvoir, Belgium.
authors.forename: Michael
authors.initials: M
authors.lastname: Dupont
authors.affiliation: Division of Pulmonology, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain Namur, Avenue G. Thérasse, 1, B5530 Yvoir, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Delaunois
authors.affiliation: Division of Pulmonology, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain Namur, Avenue G. Thérasse, 1, B5530 Yvoir, Belgium.
authors.forename: Yves
authors.initials: Y
authors.lastname: Sibille
authors.affiliation: Division of Pulmonology, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain Namur, Avenue G. Thérasse, 1, B5530 Yvoir, Belgium.
authors.forename: Caroline
authors.initials: C
authors.lastname: Dahlqvist
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000009:adverse effects / Q000295:instrumentation*; D062005:Biopsy, Large-Core Needle / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D004867:Equipment Design; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009339:Needles; D011030:Pneumothorax / Q000209:etiology; D011237:Predictive Value of Tests; D015641:Radiography, Interventional / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D013896:Thoracic Diseases / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D055815:Young Adult