Computed tomography-guided core needle biopsy for lung nodules: low-dose versus standard-dose protocols.

Abstract

Introduction: Computed tomography (CT)-guided core needle biopsy (CNB) is an essential step in the management of lung nodules (LNs). Low-dose CT (LDCT)-guided CNB has been used to decrease the radiation exposure. Aim: To evaluate the technical success, safety, diagnostic capacity, and radiation exposure to patients between LDCT-guided and standard-dose CT (SDCT)-guided CNB for LNs. Methods: This is a retrospective, single-centre study. Patients who underwent LDCT-guided or SDCT-guided CNB for LNs from January 2015 to December 2017 were included. Data on technical success, diagnostic performance, complications, and radiation exposure were collected and analysed. Results: A total of 70 and 65 patients underwent LDCT-guided and SDCT-guided CNB procedure, respectively. The technical success rates were 100% in both groups. The diagnostic yield, sensitivity, specificity, and overall diagnostic accuracy in the LDCT and SDCT groups were 71.4% and 67.7% (p = 0.637), 97.8% and 93.2% (p = 0.625), 100%, and 100%, and 98.6% and 95.4% (p = 0.560), respectively. The independent risk factor of diagnostic failure was less sample tissues (p = 0.012; 95% confidence interval: 0.033-0.651). Pneumothorax was found in 9 and 12 patients in the LDCT and SDCT groups, respectively (p = 0.369). Lung haemorrhage was found in 11 and 12 patients in the LDCT and SDCT groups, respectively (p = 0.671). The mean dose-length product was 38.3 ±17.0 mGy • cm and 376.0 ±118.7 mGy • cm in the LDCT and SDCT groups, respectively (p < 0.001). Conclusions: Compared to SDCT, LDCT-guided CNB can provide comparable safety and diagnostic performance for LNs while reducing exposure to radiation.

Low-dose versus standard-dose computed tomography-guided core needle biopsy for lung nodules: a randomized controlled trial

“…We found that the diagnostic yield of CT-guided CNB was not reduced by the low-dose CT. Furthermore, the diagnostic yield rates in both groups (68% and 65%) were similar to past investigations regarding CTguided CNB for LNs [9,17]. Similarly, Shpilberg et al [16] additionally revealed that low-dose CT did not reduce diagnostic yield for spine biopsies (low-dose group: 69%; standard-dose: 60%, P = 0.60).…”

“…Resection could make the nal diagnoses for both malignant and benign LNs. CNB-based malignancy and speci c benignity could be accepted as the nal diagnosis [8][9][10][11][12][13]. CNB-based suspected malignancy and non-speci c benignity could not be accepted as the nal diagnoses, if they were not con rmed by resection, the CT medical observation would be useful for attaining a nalized diagnostic outcome.…”

“…Compared to CT-guided CNB for lung masses, CNB for LNs is more di cult in technique due to its smaller size. Therefore, when performing CT-guided CNB for LNs, more times of CT scans are usually required to adjust the needle position and angle [9,10]. Consequently, exposing individual patients to additional radiations.…”

“…So as to decrease such unnecessary dosing during CT-guided interventions, low-dose CT procedures were employed [11]. There are also some past investigations describing low-dose CT-guided CNB in diagnosis of LNs [9,10]. However, these previous studies are retrospective in nature with the high risk of selection, comparability, and outcome.…”

Predictive model for the probability of malignancy in solitary pulmonary nodules: a meta-analysis

“…Sensitivity values were impacted by the reference standard used in included studies (P = 0.02), with higher sensitivity values being reported when the references standard included surgery and biopsy samples. While benign are SPNs are generally confirmed via surgical resection, malignancy SPNs can be confirmed via both surgery and biopsy [ 34 ]. When researchers only focused on surgically-confirmed SPNs in their studies, this markedly reduced the malignant SPN sample size, thereby constraining the sensitivity of the resultant models.…”