CT-Guided Fine-Needle Aspiration Cytology of Solitary Pulmonary Nodules*

Santambrogio, Luigi; Nosotti, Mario; Bellaviti, Nadia; Pavoni, Gianni; Radice, F; Caputo, Valentina

doi:10.1378/chest.112.2.423

Cited by 137 publications

(25 citation statements)

References 6 publications

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“…In the six cases with no obvious source of error, the presence of on-site cytopathology assessment at the time of the biopsy procedure, for evaluation of either a fine needle aspiration sample or a touch prep of a CNB, may be helpful to determine tissue viability and predict the adequacy of subsequent CNBs taken from the area. 41–45 Based on this error analysis, forthcoming clinical trials (BATTLE-2 and BATTLE-FL) have incorporated the use of real-time cytopathology assessment to determine tissue viability; and, if no clear lesion can be selected for biopsy based on the available diagnostic imaging, the IR has been requesting a FDG-PET/CT to optimize lesion selection prior to biopsy. It remains to be seen whether the implementation of these measures will improve diagnostic yield.…”

Section: Discussionmentioning

confidence: 99%

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Feasibility of Image-Guided Transthoracic Core-Needle Biopsy in the BATTLE Lung Trial

Tam

Kim

Lee

et al. 2013

Journal of Thoracic Oncology

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Purpose As therapy for non-small cell lung cancer (NSCLC) patients becomes more personalized, additional tissue in the form of core needle biopsies (CNBs) for biomarker analysis is increasingly required for determining appropriate treatment and for enrollment into clinical trials. We report our experience with small-caliber percutaneous transthoracic (PT) CNBs for the evaluation of multiple molecular biomarkers in BATTLE (Biomarker-integrated Approaches of Targeted Therapy for Lung Cancer Elimination), a personalized, targeted therapy NSCLC clinical trial. Methods The medical records of patients who underwent PTCNB for consideration of enrollment in BATTLE, were reviewed for diagnostic yield of 11 predetermined molecular markers, and procedural complications. Univariate and multivariate analyses of factors related to patient and lesion characteristics were performed to determine possible influences on diagnostic yield. Results One hundred and seventy PTCNBs were performed using 20-gauge biopsy needles in 151 NSCLC patients screened for the trial. 82.9% of the biopsy specimens were found to have adequate tumor tissue for analysis of the required biomarkers. On multivariate analysis, metastatic lesions were 5.4 times more likely to yield diagnostic tissue as compared to primary tumors (p = 0.0079). Pneumothorax and chest tube insertion rates were 15.3% and 9.4%, respectively. Conclusions Image-guided 20-gauge PTCNB is safe and provides adequate tissue for analysis of multiple biomarkers in the majority of patients being considered for enrollment into a personalized, targeted therapy NSCLC clinical trial. Metastatic lesions are more likely to yield diagnostic tissue as compared to primary tumors.

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Section: Discussionmentioning

confidence: 99%

“…Our recommendations are based partly on the results of the current study and partly on applying principles, such as on-site cytopathology assessment to improve yield, that have been tested previously in the diagnostic setting. 41–45 …”

Section: Discussionmentioning

confidence: 99%

Feasibility of Image-Guided Transthoracic Core-Needle Biopsy in the BATTLE Lung Trial

Tam

Kim

Lee

et al. 2013

Journal of Thoracic Oncology

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“…TTNA is a successful method that is performed in the diagnosis of malignant disease and the presence of a pathologist during the procedure increases the diagnostic value 1. However, it is difficult to provide this arrangement in many centers.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic efficacy of computed tomography-guided transthoracic needle aspiration and biopsy in patients with pulmonary disease

Tuna¹,

Özkaya²,

Dirican³

et al. 2013

OTT

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BackgroundComputed tomography-guided transthoracic needle aspiration (TTNA) and biopsy (TTNB) is a well established, safe, and rapid method of reaching a definitive diagnosis for most thoracic lesions. The present study aimed to determine the roles of TTNA and TTNB in the diagnosis of pulmonary diseases and to compare the results using these two techniques.MethodsTTNB and TTNA were performed in 105 patients admitted to our clinic due to peripheral pulmonary lesions between May 2005 and November 2007. Needle biopsies were performed using 18-gauge Tru-Cut® biopsy needles and aspirations was performed using 18-20-22-gauge Chiba needles.ResultsMalignant lesions diagnosed by TTNB were non-small cell lung carcinoma (51 patients, 73%), small cell lung carcinoma (nine patients, 13%), malignant tissue (three patients, 5%), lymphoma (two patients, 3%), thymoma (two patients, 3%), plasmacytoma (one patient, 1%), rhabdomyosarcoma (one patient, 1%), and metastasis (one patient, 1%). The malignant lesions diagnosed by TTNA were non-small cell lung carcinoma in eleven patients (92%) and malignant tissue in one patient (8%). Three (100%) of the benign lesions diagnosed by TTNB were granulomas and two (100%) benign lesions diagnosed by TTNA were infarctions. When the diagnostic value of TTNB and TTNA was compared, TTNB was significantly superior. Malignant lesions were identified in 70 (84%) and benign lesions were identified in three (4%) of the 83 patients in the TTNB group. Ten (12%) patients in the TTNB group could not be diagnosed. Malignant lesions were found in 12 (55%) and benign lesions were found in two (9%) of the 22 patients in the TTNA group. Negative results were obtained in eight (36%) patients. The diagnostic sensitivity, specificity, and accuracy of TTNB was calculated to be 92%, 100%, and 93%, respectively (Table 5). The diagnostic sensitivity, specificity, and accuracy of TTNA was 78%, 100%, and 82%, respectively. TTNB had a sensitivity of 92% (70/76) in malignant cases and 100% (3/3) in benign cases, while the sensitivity of TTNA in malignant and benign cases was 75% (3/4) and 67% (2/3), respectively.ConclusionTTNB is a safe and easy procedure which provides a highly accurate diagnosis of benign and malignant lung lesions without causing a significant increase in complication rates.

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“…At same time it is relatively safe method with negligible mortality and limited morbidity. 2 Hagga and Alfidi first reported computed tomography (CT) guided biopsy in 1976. Since that time CT guided FNAC is considered procedure of choice in the evaluation of focal chest lesions where ultrasound guided procedure is not possible.…”

Section: Introductionmentioning

confidence: 99%

Computed tomogram guided fine needle aspiration for lung masses: Radiologic-cytologic correlation

et al. 2017

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The primary objective was to compare the results of computed tomography (CT) finding with that of cytology. The secondary objective was to evaluate the safety of CT guided transthoracic Fine Needle Aspiration Cytolofy (FNAC) of lung lesions of various sizes and locations. From December 2014 to June 2016, under CT guidance, FNAC of lung lesion was performed on 64 cases attending KIST medical college and Kathmandu imaging diagnostic center. FNAC was performed by using spinal anesthesia needle (22G/23G). Procedures were carried out under CT guidance. Smears were prepared by materials obtained and were fixed in 95% alcohol. Dry as well as wet slides were prepared. The prepared slides were then examined under light microscope by consultant pathologist. Sixty four patients were enrolled in present study. The age of patients ranges from 24 to 87 year with mean age of 55.5 and male to female ratio of 2:1. Radiologically, out of 64 cases, 49 cases were reported as malignant and 15 cases were reported as benign lesion. However, Cytologically, 39 cases were malignant, 22 cases were benign and 3 cases were suspicious for malignancy (no definite diagnosis established). The CT scan showed Sensitivity of 97.4% to identify the malignant mass as compared to cytology findings. the Specificity, Positive and negative predictive value were calculated as 63.6%, 82.6 and 93.3% respectively. CT guided fine needle aspiration cytology (FNAC) is reliable procedure for evaluation of lung lesion. It is simple and safe procedure with high diagnostic accuracy for the diagnosis of Lung cancer. Compared to biopsy, CT guided FNAC shortens the diagnostic interval and helps in differentiating lung malignancy into different cytopathological types which aids in proper management of the malignant lesion.

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CT-Guided Fine-Needle Aspiration Cytology of Solitary Pulmonary Nodules*

Cited by 137 publications

References 6 publications

Feasibility of Image-Guided Transthoracic Core-Needle Biopsy in the BATTLE Lung Trial

Feasibility of Image-Guided Transthoracic Core-Needle Biopsy in the BATTLE Lung Trial

Diagnostic efficacy of computed tomography-guided transthoracic needle aspiration and biopsy in patients with pulmonary disease

Computed tomogram guided fine needle aspiration for lung masses: Radiologic-cytologic correlation

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