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CT-guided core needle biopsy of mediastinal nodes through a transpulmonary approach: retrospective analysis of the procedures conducted over six years

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Abstract

Purpose

To retrospectively evaluate the diagnostic performance and complications of a CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach.

Materials and 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.

Key points

• 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.

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Acknowledgements

Thanks to Professor Gang Wu who takes overall responsibility for all aspects of the study. Thanks to the Department of Veterinary Clinical Sciences of Tongji Medical College, Huazhong University of Science and Technology for their support.

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Authors and Affiliations

  1. Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, China

    Zhongyuan Yin, Zhiwen Liang, Pengcheng Li & Qiong Wang

Authors
  1. Zhongyuan Yin
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  2. Zhiwen Liang
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  3. Pengcheng Li
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  4. Qiong Wang
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Corresponding author

Correspondence to Qiong Wang.

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Guarantor

The scientific guarantor of this publication is Gang Wu.

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 study has received funding by The National Natural Science Funds (81102074) from the National Natural Science Foundation of China and The Natural Science Funds (2014CFB297) from the Natural Science Foundation of Hubei Province of China.

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 obtained from all subjects (patients) in this study.

Methodology

• retrospective

• observational/experimental

• multicenter study/performed at one institution

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Yin, Z., Liang, Z., Li, P. et al. CT-guided core needle biopsy of mediastinal nodes through a transpulmonary approach: retrospective analysis of the procedures conducted over six years. Eur Radiol 27, 3401–3407 (2017). https://doi.org/10.1007/s00330-016-4718-3

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  • DOI: https://doi.org/10.1007/s00330-016-4718-3

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