Diagnostic Accuracy of CT-Guided Core Biopsy of Ground-Glass Opacity Pulmonary Lesions

Kim, Tae Jung; Lee, Jae-Ho; Lee, Choon-Taek; Jheon, Sang Hoon; Sung, Sook Whan; Chung, Jin-Haeng; Lee, Kyungwon

doi:10.2214/ajr.07.2441

Cited by 80 publications

(57 citation statements)

References 45 publications

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“…90%, regardless of nodule size or extent of the ground glass component. 162 In another small study of 40 individuals with subsolid nodules, the diagnostic yield of CT scan-guided core needle biopsy was 84% (16 of 19), but two of three individuals with nondiagnostic results were subsequently found to have cancer. 163 Hence, although TTNB appears to be less sensitive for subsolid than for solid nodules, it is still potentially useful, particularly for individuals who are at higher risk for surgical complications and those who wish to confi rm malignancy before undergoing surgical resection.…”

Section: Role Of Nonsurgical Biopsymentioning

confidence: 98%

Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?

Gould

Donington

Lynch

et al. 2013

Chest

1,072

1,022

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we suggest that no additional diagnostic evaluation need be performed (Grade 2C) .Remark : This recommendation applies only to solid nodules. For guidance about follow-up of subsolid nodules, see Recommendations 6.5.1 to 6.5.4 . 2.3.3.In the individual with an indeterminate nodule that is identifi ed by chest radiography, we recommend that CT of the chest should be performed (preferably with thin sections Objectives: The objective of this article is to update previous evidence-based recommendations for evaluation and management of individuals with solid pulmonary nodules and to generate new recommendations for those with nonsolid nodules. Methods: We updated prior literature reviews, synthesized evidence, and formulated recommendations by using the methods described in the "Methodology for Development of Guidelines for Lung Cancer" in the American College of Chest Physicians Lung Cancer Guidelines, 3rd ed. Results: We formulated recommendations for evaluating solid pulmonary nodules that measure . 8 mm in diameter, solid nodules that measure Յ 8 mm in diameter, and subsolid nodules. The recommendations stress the value of assessing the probability of malignancy, the utility of imaging tests, the need to weigh the benefi ts and harms of different management strategies (nonsurgical biopsy, surgical resection, and surveillance with chest CT imaging), and the importance of eliciting patient preferences. Conclusions: Individuals with pulmonary nodules should be evaluated and managed by estimating the probability of malignancy, performing imaging tests to better characterize the lesions, evaluating the risks associated with various management alternatives, and eliciting their preferences for management. CHEST 2013; 143(5)(Suppl):e93S-e120SAbbreviations: AAH 5 atypical adenomatous hyperplasia; ACCP 5 American College of Chest Physicians; AIS 5 adenocarcinoma in situ; EBUS 5 endobronchial ultrasound; ENB 5 electromagnetic navigation bronchoscopy; FDG 5 fl uorodeoxyglucose; HU 5 Hounsfi eld unit; LR 5 likelihood ratio; SPECT 5 single-photon emission CT; TBB 5 transbronchial biopsy; TTNB 5 transthoracic needle biopsy; VATS 5 video-assisted thoracic surgery; VBN 5 virtual bronchoscopy navigation; VDT 5 volume doubling time

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Section: Role Of Nonsurgical Biopsymentioning

confidence: 98%

Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?

Gould

Donington

Lynch

et al. 2013

Chest

1,072

1,022

View full text Add to dashboard Cite

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“…Notably, the diagnostic accuracy of CT fluoroscopy-guided needle aspiration or core biopsy for pure GGNs was lower than that for part-solid GGNs (45,49), which would be due to the low cellularity of pure GGNs (45). However, Kim et al (46), using CT-guided core biopsy, reported conflicting results that the diagnostic accuracy was not influenced by the proportion of the GGO component. We do not currently have a definite conclusion on whether biopsy would provide accurate diagnosis for SSNs.…”

Section: Imaging-guided Biopsy Of Subsolid Nodulesmentioning

confidence: 99%

“…With respect to the biopsy of SSNs, several CT-based approaches including sequential CT-guided-biopsy, CT fluoroscopy-guided biopsy, and cone-beam CT (CBCT) virtual-navigation-guided biopsy have been introduced (45)(46)(47)(48)(49). Either a fine needle aspiration biopsy or a core biopsy can be used, but core biopsy showed higher diagnostic accuracy (46,49).…”

Section: Imaging-guided Biopsy Of Subsolid Nodulesmentioning

confidence: 99%

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Pulmonary subsolid nodules: what radiologists need to know about the imaging features and management strategy

Kim¹,

Park²,

Koh³

et al. 2013

Diagn Interv Radiol

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“…However, the diagnostic sensitivity of CTNB ranges from 64% to 93% and the complication rate is relatively high; pneumothorax occurs in 18%-47%, and hemoptysis in 13%-20%. [6][7][8] Both procedures have strong and weak points, and the challenge is to combine the respective strong points of bronchoscopy and CTNB. In cases wherein the EBUS probe is adjacent to lesions, the combination of EBUS and transbronchial needle aspiration (TBNA) has been demonstrated to be useful and safe.…”

Section: Introductionmentioning

confidence: 99%

Transbronchial Needle Aspiration through a Guide Sheath with Endobronchial Ultrasonography (GS-TBNA) for Peripheral Pulmonary Lesions

Takai

Izumo

Chavez

et al. 2014

ATCS

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Purpose: Although, endobronchial ultrasonography with a guide sheath is becoming a common procedure for the diagnosis of peripheral pulmonary lesions, there remain to be some inaccuracies in cases wherein the probe is located outside the lesion. We tested whether adding transbronchial needle aspiration through a guide sheath to the conventional technique increases efficacy for diagnosing peripheral pulmonary lesions. Methods: We performed transbronchial needle aspiration through a guide sheath for 37 subjects with peripheral pulmonary lesions between September 2012 and April 2013. The devices used were as follows (all Olympus Ltd., Tokyo, Japan): 1T-260 or LF-TP bronchoscope, K203 guide sheath kit and NA-1C-1 needle apparatus, customized by cutting the guide sheath 30 mm from the proximal end to fit well with the needle. Results: The endobronchial ultrasound probe was located within the lesion in 21 cases (56.8%) and outside in 16 cases (43.2%). Overall accuracy was 86.5 percent; 90.5% in "within" cases compared to 81.3% in "outside" cases with no significant difference (P = 0.42). Pneumothorax occurred in 2 cases and pneumonia in 1 case. Conclusion: Transbronchial needle aspiration through a guide sheath is an effective and safe diagnostic procedure for peripheral pulmonary lesions, especially when the guide sheath is outside the lesion.

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Diagnostic Accuracy of CT-Guided Core Biopsy of Ground-Glass Opacity Pulmonary Lesions

Cited by 80 publications

References 45 publications

Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?

Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?

Pulmonary subsolid nodules: what radiologists need to know about the imaging features and management strategy

Transbronchial Needle Aspiration through a Guide Sheath with Endobronchial Ultrasonography (GS-TBNA) for Peripheral Pulmonary Lesions

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