“…The 93% accuracy rate with percutaneous hilar biopsies seen in this study is comparable to the accuracy rates reported with a combination of endobronchial ultrasound-and EUS-guided FNAB 14 and is at the upper end of the range for the accuracy rates reported for image-guided mediastinal biopsies (78%-94%) [8][9][10][11][12][13] and lung biopsies (88%-95%). [3][4][5][6][7]24,25 The diagnostic yield of endobronchial ultrasound may be increased by electromagnetic navigation techniques that allow biopsy of endobronchially invisible pulmonary lesions. 26 EUS-guided procedures allow only fine-needle aspiration of individual cells, which is usually sufficient for staging purposes.…”
BACKGROUND: Because of their proximity to the pulmonary artery or vein, hilar lymph nodes are routinely biopsied with endobronchial or endoscopic ultrasonography (EUS)-guided fine-needle aspiration biopsy (FNAB). Computed tomography (CT)-guided percutaneous needle biopsy (PNB) allows the operator to acquire a larger core needle biopsy (CNB) when initial samples are inconclusive, when the suspected disease is not optimally diagnosed with FNAB, or when biomarkers are required. The purpose of this study was to retrospectively evaluate the sensitivity and accuracy of CT-guided PNB in patients with hilar adenopathy. METHODS: The authors identified 80 patients who underwent 81 CT-guided PNBs of pulmonary hilar lesions from October 2002 through December 2006 and retrospectively reviewed their medical and imaging records. The PNB sensitivity and accuracy were calculated in each case, and each case was reviewed for complications, including pneumothorax and subsequent thoracostomy tube insertion. RESULTS: PNB included FNAB and CNB in 81 (100%) and 14 (17%) procedures, respectively. Data on 69 PNB specimens (67 FNAB specimens and 13 CNB specimens) were available for statistical analysis. Overall, PNB had a sensitivity of 91.4% (95% confidence interval [CI], 81.0%-97.1%) and an accuracy rate of 92.8% (95% CI, 83.9%-97.1%). Pneumothoraxes occurred in 39 patients (48%), 26 (32%) of whom required thoracostomy tube insertion. CONCLU-SIONS: CT-guided PNB of pulmonary hilar lesions has high sensitivity and accuracy and represents a viable alternative for endobronchial ultrasound-or EUS-guided FNAB when larger biopsy samples are required for diagnosis or biomarker analysis. However, the procedure can result in high rates of pneumothorax.
“…The 93% accuracy rate with percutaneous hilar biopsies seen in this study is comparable to the accuracy rates reported with a combination of endobronchial ultrasound-and EUS-guided FNAB 14 and is at the upper end of the range for the accuracy rates reported for image-guided mediastinal biopsies (78%-94%) [8][9][10][11][12][13] and lung biopsies (88%-95%). [3][4][5][6][7]24,25 The diagnostic yield of endobronchial ultrasound may be increased by electromagnetic navigation techniques that allow biopsy of endobronchially invisible pulmonary lesions. 26 EUS-guided procedures allow only fine-needle aspiration of individual cells, which is usually sufficient for staging purposes.…”
BACKGROUND: Because of their proximity to the pulmonary artery or vein, hilar lymph nodes are routinely biopsied with endobronchial or endoscopic ultrasonography (EUS)-guided fine-needle aspiration biopsy (FNAB). Computed tomography (CT)-guided percutaneous needle biopsy (PNB) allows the operator to acquire a larger core needle biopsy (CNB) when initial samples are inconclusive, when the suspected disease is not optimally diagnosed with FNAB, or when biomarkers are required. The purpose of this study was to retrospectively evaluate the sensitivity and accuracy of CT-guided PNB in patients with hilar adenopathy. METHODS: The authors identified 80 patients who underwent 81 CT-guided PNBs of pulmonary hilar lesions from October 2002 through December 2006 and retrospectively reviewed their medical and imaging records. The PNB sensitivity and accuracy were calculated in each case, and each case was reviewed for complications, including pneumothorax and subsequent thoracostomy tube insertion. RESULTS: PNB included FNAB and CNB in 81 (100%) and 14 (17%) procedures, respectively. Data on 69 PNB specimens (67 FNAB specimens and 13 CNB specimens) were available for statistical analysis. Overall, PNB had a sensitivity of 91.4% (95% confidence interval [CI], 81.0%-97.1%) and an accuracy rate of 92.8% (95% CI, 83.9%-97.1%). Pneumothoraxes occurred in 39 patients (48%), 26 (32%) of whom required thoracostomy tube insertion. CONCLU-SIONS: CT-guided PNB of pulmonary hilar lesions has high sensitivity and accuracy and represents a viable alternative for endobronchial ultrasound-or EUS-guided FNAB when larger biopsy samples are required for diagnosis or biomarker analysis. However, the procedure can result in high rates of pneumothorax.
“…El rendimiento global de la BP en este estudio fue de 91,5%, con una sensibilidad de 90,6% para el diagnóstico de lesiones malignas, resultados similares a los publicados en series internacionales [3][4][5][6] . La patología maligna fue la más común, siendo los tumores broncogénicos primarios y las lesiones metastásicas los diagnósticos más frecuentes, datos que concuerdan con casuísticas previas.…”
Section: Discussionunclassified
“…El tamaño lesional es un factor importante y ampliamente estudiado, con una menor sensibilidad de la técnica reportada en lesiones menores a 15 mm y mayores a 5 cm, estas últimas por un mayor porcentaje de necrosis asociada 6,19 . En nuestro estudio no observamos una relación entre el tamaño de la lesión y el rendimiento de la técnica, probablemente por el bajo porcentaje de lesiones menores a 20 mm.…”
Section: Discussionunclassified
“…Algunas ventajas del método son su carácter no invasivo, baja tasa de complicaciones y menor costo 1,2 . El rendimiento reportado de la técnica fluctúa entre 83% y 99% en el caso de LP [3][4][5][6] . Yeow KM et al 6 , en una serie de 631 LP estudiadas con BP core guiada por TC, demostraron rendimientos de 99% para lesiones malignas y 86% para lesiones benignas, con un mejor rendimiento a mayor tamaño lesional (< 1,5 cm 84% y 1,5-5 cm 96%).…”
“…Although highly specific (99.1%), CT-CB are prone to false negatives, with a reported negative predictive value of only 73.3% (13). Furthermore, the accuracy of CT-CB appears to worsen in lung lesions <1.5, >5 cm (increased extent of necrosis) and those with a benign histology (14). A meta-analysis of 32 studies revealed that CT-CB and CT-FNAB have high overall complication rates of 39% and 24% respectively.…”
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