title: CT-Guided Percutaneous Lung Biopsies in Patients With Suspicion for Infection May Yield Clinically Useful Information.
abstract: OBJECTIVE
  The objective of our study was to assess the frequency and time frame with which CT-guided lung biopsies for suspected infection yield information that can affect patient management.
  
  
  METHODS
  All CT-guided lung biopsies over a 68-month period performed for the purpose of diagnosing a suspected infection were reviewed to determine the proportion that yielded information affecting patient management. Patients were included if infection was the only consideration causing the pulmonary lesion in question.
  
  
  RESULTS
  Twenty-one biopsies were performed to identify a specific organism causing infection in patients with suspected infection; all patients were receiving antibiotics, 20 (95%) were immunocompromised, and 15 (71%) had undergone a prior bronchoscopy. Material collected from the biopsy provided a diagnosis in nine (43%) patients, whereas the biopsy results were nondiagnostic in the remaining 12 (57%). Of the nine patients for whom the biopsy yielded a diagnosis, eight biopsies revealed the species causing an infection (38%) and one biopsy (5%) detected posttransplant lymphoproliferative disease. Of the nine diagnoses, management was changed as a result of the biopsy in six patients (29% of all patients). The organisms identified by CT-guided lung biopsy in eight patients were fungi of the order Mucorales (i.e., mucormycosis) (n = 3), Aspergillus (n = 3), Pseudomonas (n = 1), and Nocardia (n = 1). The mean elapsed time between biopsy and pathologic diagnosis was 4 days (median, 3 days). There was no association between prior bronchoscopy and nondiagnostic biopsy results.
  
  
  CONCLUSIONS
  CT-guided lung biopsies in patients with a high pretest suspicion for infection result in information sufficient to change patient management in 29% of patients. Organisms identified in these patients were most frequently fungi.
authors.affiliation: 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, M-391, Box 0628, San Francisco, CA 94143.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Haas
authors.affiliation: 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, M-391, Box 0628, San Francisco, CA 94143.
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Clayton
authors.affiliation: 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, M-391, Box 0628, San Francisco, CA 94143.
authors.forename: Brett M
authors.initials: BM
authors.lastname: Elicker
authors.affiliation: 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, M-391, Box 0628, San Francisco, CA 94143.
authors.forename: Karen G
authors.initials: KG
authors.lastname: Ordovas
authors.affiliation: 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, M-391, Box 0628, San Francisco, CA 94143.
authors.forename: David M
authors.initials: DM
authors.lastname: Naeger
mesh_terms: D000328:Adult; D000368:Aged; D003141:Communicable Diseases / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008171:Lung Diseases / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012495:San Francisco / Q000453:epidemiology; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*
keywords: immunocompromise; lung biopsy; pneumonia; pulmonary consolidations