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Diagnostic feasibility and safety of CT-guided core biopsy for lung nodules less than or equal to 8 mm: A single-institution experience

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Abstract

Objectives

This retrospective study evaluated the diagnostic yield and safety of CT-guided core biopsy of pulmonary nodules ≤8 mm.

Methods

We determined the diagnostic yield and safety profile of CT-guided lung biopsies for 125 pulmonary nodules ≤8 mm. Pathological diagnoses were made by a combination of histopathological examination and imprint cytology. Results were compared with biopsy results for 134 pulmonary nodules >8 and ≤10 mm.

Results

Final diagnoses were established in 94 nodules ≤8 mm. The sensitivity, specificity and diagnostic accuracy of CT-guided core biopsy for nodules ≤8 mm were 87.1 % (61/70 nodules), 100 % (24/24) and 90.4 % (85/94), respectively. Diagnostic failure rates were comparable for nodules ≤8 mm and nodules >8 mm and ≤10 mm (9/94, 9.6 % and 7/111, 6.3 %, respectively, P=0.385). The rate of tube thoracostomy for nodules ≤8 mm was comparable to that for nodules >8 and ≤10 mm (1.6 % vs. 0.7 %, P=0.611). Nodules ≤6 mm had a higher non-diagnostic result rate of 15.4 % (6/39) than did nodules >8 and ≤10 mm (3.7 %, 5/134, P=0.017).

Conclusions

CT-guided pulmonary biopsy is feasible for lung nodules ≤8 mm, especially those >6 mm, and has an acceptable diagnostic yield and safety profile.

Key Points

• CT-guided biopsy of lung nodules ≤8 mm has high diagnostic accuracy.

• Safety profiles are similar between nodules ≤8 mm and 8–10 mm.

• Nodules ≤6 mm have higher rates of non-diagnostic results in biopsy.

• Non-subpleural nodules and old age are risk factors for higher grade haemorrhage.

• Biopsy is feasible for diagnosing nodules >6 and ≤8 mm.

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Abbreviations

CXR:

Chest radiography

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Authors and Affiliations

  1. Department of Radiology, Taipei Veterans General Hospital, 201, Sec. 2, Shipai Rd., Taipei, 112, Taiwan

    Ying-Yueh Chang, Chun-Ku Chen & Mei-Han Wu

  2. School of Medicine, National Yang-Ming University, 155, Sec. 2, Linong St., Taipei, 112, Taiwan

    Chun-Ku Chen, Yi-Chen Yeh & Mei-Han Wu

  3. Institute of Clinical Medicine, National Yang-Ming University, 155, Sec. 2, Linong St., Taipei, 112, Taiwan

    Chun-Ku Chen

  4. Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, 201, Sec. 2, Shipai Rd., Taipei, 112, Taiwan

    Yi-Chen Yeh

Authors
  1. Ying-Yueh Chang
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  2. Chun-Ku Chen
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Corresponding author

Correspondence to Chun-Ku Chen.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Chun-Ku Chen, MD, MHA.

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

The authors state that this work has not received any funding.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent for review of the images and medical records was waived by the Institutional Review Board. However, informed consent for biopsy or aspiration was obtained from all patients prior to procedure.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• Retrospective

• Observational

• Performed at one institution

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Cite this article

Chang, YY., Chen, CK., Yeh, YC. et al. Diagnostic feasibility and safety of CT-guided core biopsy for lung nodules less than or equal to 8 mm: A single-institution experience. Eur Radiol 28, 796–806 (2018). https://doi.org/10.1007/s00330-017-5027-1

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  • DOI: https://doi.org/10.1007/s00330-017-5027-1

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