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CT-guided fine-needle ago-biopsy of pulmonary nodules: predictive factors for diagnosis and pneumothorax occurrence

  • CHEST RADIOLOGY
  • Published:
La radiologia medica Aims and scope Submit manuscript

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.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Catholic University of Sacred Heart, Largo F. Vito n 1, Rome, Italy

    Marco Chiappetta, Leda Marina Pomes, Leonardo Petracca Ciavarella, Stefano Margaritora & Pierluigi Granone

  2. Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital-Catholic University, Rome, Italy

    Francesco Rosella & Tommaso Pirronti

  3. Unit of Clinical and Molecular Epidemiology, IRCCS San Raffaele Pisana, Rome, Italy

    Valentina Dall’armi

  4. Department of Thoracic Surgery, Catholic University of Sacred Heart, Largo F. Vito n 1, Rome, Italy

    Dania Nachira

Authors
  1. Marco Chiappetta
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  2. Francesco Rosella
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  3. Valentina Dall’armi
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  4. Leda Marina Pomes
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  6. Dania Nachira
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  7. Tommaso Pirronti
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  8. Stefano Margaritora
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  9. Pierluigi Granone
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Correspondence to Marco Chiappetta.

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None declared.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Chiappetta, M., Rosella, F., Dall’armi, V. et al. CT-guided fine-needle ago-biopsy of pulmonary nodules: predictive factors for diagnosis and pneumothorax occurrence. Radiol med 121, 635–643 (2016). https://doi.org/10.1007/s11547-016-0639-0

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  • DOI: https://doi.org/10.1007/s11547-016-0639-0

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