title: CT-guided fine-needle ago-biopsy of pulmonary nodules: predictive factors for diagnosis and pneumothorax occurrence.
abstract: OBJECTIVE
  To evaluate variables that could predict diagnosis during CT-guided fine-needle aspiration.
  
  
  METHODS
  Data from 249 patients who underwent FNAB from January 2010 to December 2012 were analyzed in a retrospective observational study.
  
  
  RESULTS
  Mean age was 66.7 ± 11.5 years, male/female ratio 158/91 (63 vs. 37 %). The nodules were in right lung in 123 patients (49 %), in left lung in 126 patients (51 %), the upper, lower and middle lobe localizations were, respectively in 122 (49 %), 100 (40 %) and 17 (6 %) patients. Mean nodule-chest wall distance was 63.89 ± 21.38 mm. The tumor location, the needle diameter, the presence of necrosis or cavitation, the node-chest wall distance and the number of passages were not related to the diagnostic outcome (p = NS). The nodule diameter was predictive of diagnosis. Odds ratio for a 10-30 mm tumor was 2.51 (95 % OR: 1.24-5.08, p value = 0.011), the odds ratio for a 30-50 mm tumor was 2.39 (95 % OR: 1.22-4.69, p value = 0.011), and the odds ratio for a tumor larger than 50 mm was 4.44 (95 % OR: 1.89-10.44, p value = 0.001). Post-procedure pneumothorax occurred in 62 cases (25 %). The determinant factors for pneumothorax occurrence were emphysema, odds ratio 6.87 (95 % CI 1.07-44.10, p value = 0.04), and the number of pleural passages, odds ratio of 5.47 (95 % OR: 1.92-15.58), 7.44 (95 % OR: 2.58-21.5), 6.13 (95 % OR: 2.07-18.11) p value = 0.001 for one, two, three or more of three passages, respectively.
  
  
  CONCLUSIONS
  In our experience, nodule size is the most important diagnostic factor during fine-needle aspiration, while the number of passages and the presence of emphysema constitute risk factors for pneumothorax occurrence.
authors.affiliation: Department of Thoracic Surgery, Catholic University of Sacred Heart, Largo F. Vito n 1, Rome, Italy. marcokiaps@hotmail.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Chiappetta
authors.affiliation: Department of Bioimaging and Radiological Sciences, Institute of Radiology, "A. Gemelli" Hospital-Catholic University, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Rosella
authors.affiliation: Unit of Clinical and Molecular Epidemiology, IRCCS San Raffaele Pisana, Rome, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Dall'armi
authors.affiliation: Department of Thoracic Surgery, Catholic University of Sacred Heart, Largo F. Vito n 1, Rome, Italy.
authors.forename: Leda Marina
authors.initials: LM
authors.lastname: Pomes
authors.affiliation: Department of Thoracic Surgery, Catholic University of Sacred Heart, Largo F. Vito n 1, Rome, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Petracca Ciavarella
authors.affiliation: Department of Thoracic Surgery, Catholic University of Sacred Heart, Largo F. Vito n 1, Rome, Italy.
authors.forename: Dania
authors.initials: D
authors.lastname: Nachira
authors.affiliation: Department of Bioimaging and Radiological Sciences, Institute of Radiology, "A. Gemelli" Hospital-Catholic University, Rome, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Pirronti
authors.affiliation: Department of Thoracic Surgery, Catholic University of Sacred Heart, Largo F. Vito n 1, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Margaritora
authors.affiliation: Department of Thoracic Surgery, Catholic University of Sacred Heart, Largo F. Vito n 1, Rome, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Granone
mesh_terms: D000368:Aged; D044963:Biopsy, Fine-Needle / Q000009:adverse effects; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D055613:Multiple Pulmonary Nodules / Q000473:pathology*; D011030:Pneumothorax / Q000209:etiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors
keywords: FNAB; Lung biopsy; Lung cancer; Pneumothorax