Skip to main content

Advertisement

Log in

Factors influencing accuracy of CT-guided percutaneous biopsies of pulmonary lesions

  • Chest
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

The purpose of this study was to evaluate the performance and complication rate of CT-guided percutaneous lung biopsy of pulmonary lesions using a coaxial automated biopsy device and to determine factors influencing the false negative rate for the diagnosis of malignancy. A prospective study of 605 consecutive biopsies performed in 595 patients was undertaken. The performances for the diagnosis of malignancy, for the specific diagnosis of benignity and the complication rate were calculated. Patients’ characteristics and lesion and procedure variables were included in a logistic regression model and analyzed as potential predictive variables for occurrence of a false-negative diagnosis of malignancy. The sensitivity, specificity, positive predictive value and negative predictive value for a diagnosis of malignancy were 92.2, 99.1, 99.8 and 73.3%, respectively. A specific diagnosis of benignity was obtained in 43 cases (40%) biopsies. The pneumothorax rate was 17.4% (n=105) with 3 (0.5%) requiring drainage. At multivariate analysis, the sole variable significantly associated with a higher rate of false negative diagnosis of malignancy was lesion size equal to or smaller than 10 mm in diameter. Using a coaxial automated device, CT-guided percutaneous biopsy of pulmonary lesions of size equal to or less than 10 mm in diameter provides a high diagnostic yield with an acceptable complication rate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Westcott JL (1980) Direct percutaneous needle aspiration of localized pulmonary lesions: result in 422 patients. Radiology 137:31–35

    PubMed  Google Scholar 

  2. Miller DA, Carrasco CH, Katz RL, Cramer FM, Wallace S, Charnsangavej C (1986) Fine needle aspiration biopsy: the role of immediate cytologic assessment. Am J Roentgenol 147:155–158

    CAS  Google Scholar 

  3. Austin JH, Cohen MB (1993) Value of having a cytopathologist present during percutaneous fine-needle aspiration biopsy of lung: report of 55 cancer patients and metaanalysis of the literature. Am J Roentgenol 160:175–177

    Google Scholar 

  4. Padhani AR, Scott WW Jr, Cheema M, Kearney D, Erozan YS (1997) The value of immediate cytologic evaluation for needle aspiration lung biopsy. Invest Radiol 32:453–458

    Article  CAS  PubMed  Google Scholar 

  5. Lucidarme O, Howarth N, Finet JF, Grenier PA (1998) Intrapulmonary lesions: percutaneous automated biopsy with a detachable, 18-gauge, coaxial cutting needle. Radiology 207:759–765

    CAS  PubMed  Google Scholar 

  6. Moulton JS, Moore PT (1993) Coaxial percutaneous biopsy technique with automated biopsy devices: value in improving accuracy and negative predictive value. Radiology 186:515–522

    CAS  PubMed  Google Scholar 

  7. Arakawa H, Nakajima Y, Kurihara Y, Niimi H, Ishikawa T (1996) CT-guided transthoracic needle biopsy: a comparison between automated biopsy gun and fine needle aspiration. Clin Radiol 51:503–506

    PubMed  Google Scholar 

  8. Klein JS, Salomon G, Stewart EA (1996) Transthoracic needle biopsy with a coaxially placed 20-gauge automated cutting needle: results in 122 patients. Radiology 198:715–720

    PubMed  Google Scholar 

  9. Laurent F, Latrabe V, Vergier B, Montaudon M, Vernejoux JM, Dubrez J (2000) CT-guided transthoracic needle biopsy of pulmonary nodules smaller than 20 mm: results with an automated 20-gauge coaxial cutting needle. Clin Radiol 55:281–287

    Article  CAS  PubMed  Google Scholar 

  10. Hosmer DWLS (1989) Applied logistic regression. Wiley, New York

  11. Berquist TH, Bailey PB, Cortese DA, Miller WE (1980) Transthoracic needle biopsy: accuracy and complications in relation to location and type of lesion. Mayo Clin Proc 55:475–481

    CAS  PubMed  Google Scholar 

  12. Westcott JL, Rao N, Colley DP (1997) Transthoracic needle biopsy of small pulmonary nodules. Radiology 202:97–103

    PubMed  Google Scholar 

  13. Bocking A, Klose KC, Kyll HJ, Hauptmann S (1995) Cytologic versus histologic evaluation of needle biopsy of the lung, hilum and mediastinum. Sensitivity, specificity and typing accuracy. Acta Cytol 39:463–471

    CAS  PubMed  Google Scholar 

  14. Oikonomou A, Matzinger FR, Seely JM, Dennie CJ, Macleod PJ (2003) Ultrathin needle (25 G) aspiration lung biopsy: diagnostic accuracy and complication rates. Eur Radiol 13:20

    Google Scholar 

  15. Hahn PF, Eisenberg PJ, Pitman MB, Gazelle GS, Mueller PR (1995) Cytopathologic touch preparations (imprints) from core needle biopsies: accuracy compared with that of fine-needle aspirates. Am J Roentgenol 165:1277–1279

    CAS  Google Scholar 

  16. Yamagami T, Shigeharu L, Takeharu K, Tanaka O, Nishimura M (2003) Combining fine-needle aspiration and core biopsy under CT fluoroscopy guidance: a better way to treat patients with lung nodules. Am J Roentgenol 180:811–815

    Google Scholar 

  17. Tsukada H, Satou T, Iwashima A, Souma T (2000) Diagnostic accuracy of CT-guided automated needle biopsy of lung nodules. Am J Roentgenol 175:239–243

    CAS  Google Scholar 

  18. Wallace MJ, Krishnamurthy S, Broemeling LD, Gupta S, Ahrar K, Morello FA Jr et al (2002) CT-guided percutaneous fine-needle aspiration biopsy of small (≤1-cm) pulmonary lesions. Radiology 225:823–828

    PubMed  Google Scholar 

  19. Boiselle PM, Shepard JA, Mark EJ, Szyfelbein WM, Fan CM, Slanetz PJ et al (1997) Routine addition of an automated biopsy device to fine-needle aspiration of the lung: a prospective assessment. Am J Roentgenol 169:661–666

    CAS  Google Scholar 

  20. McLoud TC (1998) Should cutting needles replace needle aspiration of lung lesions? Radiology 207:569–570

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to François Laurent.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Montaudon, M., Latrabe, V., Pariente, A. et al. Factors influencing accuracy of CT-guided percutaneous biopsies of pulmonary lesions. Eur Radiol 14, 1234–1240 (2004). https://doi.org/10.1007/s00330-004-2250-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-004-2250-3

Keywords

Navigation