title: CT-guided core needle biopsy of mediastinal nodes through a transpulmonary approach: retrospective analysis of the procedures conducted over six years.
abstract: OBJECTIVE
  To retrospectively evaluate the diagnostic performance and complications of a CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach.
  
  
  METHODS
  From January 2009 to December 2014, we used a coaxial positioning system and an 18G cutting-type biopsy device to perform CT-guided percutaneous transpulmonary needle biopsies of mediastinal nodes for 127 patients. The diagnostic performance, complication rate, influencing factors, distribution of mediastinal nodes and pathological diagnoses were investigated.
  
  
  RESULTS
  Among 127 patients, pathologic analyses showed that all of the biopsies were technically successful. The sensitivity, specificity, positive predictive value, and negative predictive value were all 100%. As for complications, the ratios for pneumothorax and hemoptysis were 33.9% and 4.7%, respectively. Multivariate analyses revealed that the distance from the pleura to the target lesion (P = 0.008) and the numbers of visceral pleura injuries (P = 0.006) were the two most significant risk factors for pneumothorax, and that the distance from the pleura to the target lesion (P = 0.004) was the most significant risk factor for hemoptysis.
  
  
  CONCLUSIONS
  CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach is a safe and efficient diagnostic method.
  
  
  CONCLUSIONS
  • CT-guided core needle biopsy is an accurate technique for diagnosing mediastinal nodes. • The rates of complications are similar to those for pulmonary lesion biopsy. • Pneumothorax risk factors include distance from pleura to target lesion and number of visceral pleura. • Distance from pleura to target lesion is the risk factor for hemoptysis. • CT-guided core needle biopsy is an important diagnostic method for mediastinal nodes.
authors.affiliation: Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, China.
authors.forename: Zhongyuan
authors.initials: Z
authors.lastname: Yin
authors.affiliation: Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, China.
authors.forename: Zhiwen
authors.initials: Z
authors.lastname: Liang
authors.affiliation: Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, China.
authors.forename: Pengcheng
authors.initials: P
authors.lastname: Li
authors.affiliation: Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, China. wdyxywq@163.com.
authors.forename: Qiong
authors.initials: Q
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D062005:Biopsy, Large-Core Needle / Q000009:adverse effects / Q000379:methods; D001707:Biopsy, Needle / Q000379:methods; D005260:Female; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects / Q000379:methods*; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D000072281:Lymphadenopathy / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging; D008875:Middle Aged; D056888:Patient Positioning; D010994:Pleura / Q000293:injuries; D011030:Pneumothorax / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000379:methods
keywords: Biopsy; CT-guided; Core needle; Mediastinal nodes; Percutaneous