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Non-specific benign pathological results on transthoracic core-needle biopsy: how to differentiate false-negatives?

  • Chest
  • Published:
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Abstract

Objectives

To determine the negative predictive value (NPV) of non-specific benign results from cone-beam CT (CBCT)-guided transthoracic core-needle biopsy (TTNB) and identify predicting factors for false-negative for malignancies.

Methods

From January 2009–December 2011, 1,108 consecutive patients with 1,116 lung lesions underwent CBCT-guided TTNB using an 18-gauge coaxial cutting needle. Among them, 226 patients with 226 TTNBs, initially diagnosed as non-specific benign, were included in this study. The medical charts, radiological or pathological follow-ups were reviewed to classify false-negative and true-negative results and to identify which variables were associated with false-negatives.

Results

Of 226 lesions, 24 (10.6%) were finally confirmed as malignancies and 202 (89.4%) as benign, of which the NPV was 89.4% (202/226). Multivariate analysis revealed that part-solid nodule (PSN) (odds ratio (OR), 3.95; P = 0.022), a biopsy result of ‘granulomatous inflammation’ (OR, 0.04; P = 0.022), and exact location of needle tip within targets (OR, 0.37; P = 0.045) were significantly associated with false-negatives among initial non-specific benign biopsy results.

Conclusion

The NPV of the non-specific benign biopsy was 89.4%. PSN was a significant positive indicator, but a biopsy result of ‘granulomatous inflammation’ and exact location of needle tip within targets were significant negative indicators for false-negatives.

Key Points

• The negative predictive value of the non-specific benign biopsy was 89.4%.

• A part-solid nodule is a significant predictor for false-negative biopsy (OR = 3.95).

• Pathological diagnosis of granulomatous inflammation is a robust indicator for ‘true-negatives’.

• Identifying needle tip within target lesions is a significant predictor for ‘true-negatives’.

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Abbreviations

CBCT:

Cone-beam computed tomography

FDG-PET:

Fluorodeoxyglucose (18F-FDG) positron emission tomography

NPV:

Negative predictive value

PSN:

Part-solid nodule

TTNB:

Transthoracic core-needle biopsy

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Author information

Author notes

  1. Jung Im Kim

    Present address: Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea

Authors and Affiliations

  1. Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea

    Jung Im Kim, Chang Min Park, Hyungjin Kim, Jong Hyuk Lee & Jin Mo Goo

  2. Cancer Research Institute, Seoul National University, Seoul, Korea

    Chang Min Park & Jin Mo Goo

Authors
  1. Jung Im Kim
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  2. Chang Min Park
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Corresponding author

Correspondence to Chang Min Park.

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Guarantor

The scientific guarantor of this publication is Chang Min Park.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Funding

This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI) funded by the Ministry of Health & Welfare, Republic of Korea (grant number : HC15C3390).

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported (Kim JI, Park CM, Lee SM, Goo JM (2015) Rapid needle-out patient-rollover approach after cone beam CT-guided lung biopsy: effect on pneumothorax rate in 1,191 consecutive patients. Eur Radiol 25:1845–1853)

Methodology

• retrospective

• cross-sectional study

• performed at one institution

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Cite this article

Kim, J.I., Park, C.M., Kim, H. et al. Non-specific benign pathological results on transthoracic core-needle biopsy: how to differentiate false-negatives?. Eur Radiol 27, 3888–3895 (2017). https://doi.org/10.1007/s00330-017-4766-3

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  • DOI: https://doi.org/10.1007/s00330-017-4766-3

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