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

Abstract

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.

A prospective study on the diagnosis of peripheral lung cancer using endobronchial ultrasonography with a guide sheath and computed tomography-guided transthoracic needle aspiration

“…The primary negative results of CT-TTNA might be false negatives, 12 so in this study some patients had two or three operations. Computed tomography-guided transthoracic needle biopsy (CT-TTNB) 13 had a higher diagnosis rate of malignant disease than did CT-TTNA, but the small PPLs in this study were not suitable for CT-TTNB. For lesions around 20 mm, electromagnetic navigation bronchoscopy (ENB) can be considered if neither method can obtain the specimens.…”

Pneumothorax with prolonged chest tube requirement after CT-guided percutaneous lung biopsy: incidence and risk factors

“…Some studies indicate that core biopsies provide a more accurate diagnosis than fine needle aspiration (FNA) [3] while others suggest that a combination of FNA and core biopsy specimens maximize the likelihood of providing a diagnostic specimen in a given patient [6; 7]. In light of its high diagnostic value with either strategy, CPLB is a common procedure in the clinical workup of concerning lung lesions—especially those that are inaccessible by transbronchial methods.…”

Combination of electromagnetic navigation bronchoscopy-guided biopsy with a novel staining for peripheral pulmonary lesions

“…In the preoperatively diagnostic process, sensitivity and specificity of positron emission tomography-computed tomography (PET/CT) were 88% and 77%, respectively [3]. Meanwhile, the accuracy of percutaneous CT-guided pulmonary biopsy is not satisfactory, and the puncture may lead to pneumothorax and metastasis [4]. The detection rate of bronchoscopy with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is closely associated with the size and location of the tumor, in which the detection rate is about 63% for lesion > 2 cm, and that is reduced to 34% for lesion < 2 cm [5].…”