Percutaneous needle aspiration biopsy (PCNAB) of lung lesions: 5 years results with focusing on repeat PCNAB

Lee, In Jae; Bae, Young-A; Kim, Dong Gyu; Jung, Ki‐Suck; Im, Hyoung June; Lee, Kwanseop; Lee, Yul; Bae, Sang Hoon

doi:10.1016/j.ejrad.2009.01.009

Cited by 12 publications

(15 citation statements)

References 16 publications

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“…The rate of hemoptysis was comparable to that reported in the literature for PCNB of small nodules (1)(2)(3)12). In this study, there was no statistically significant difference in the development of hemoptysis between the different imaging guidance modalities.…”

Section: Volume 18 • Issuesupporting

confidence: 76%

“…PCNB is generally regarded as a safe procedure with limited morbidity and extremely rare mortality (2)(3)(4)(5). Biopsies of pulmonary lesions as small as 3 mm in diameter have been reported (6,7).…”

mentioning

confidence: 99%

“…ercutaneous core needle biopsy (PCNB) of the lung is a well-established method for the cytological diagnosis of pulmonary nodules (1,2). PCNB is generally regarded as a safe procedure with limited morbidity and extremely rare mortality (2)(3)(4)(5).…”

mentioning

confidence: 99%

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Percutaneous core needle biopsy for small lung nodules with diameters ≤ 10 mm: accurate diagnosis and complication rates

Jae

June²,

Yie³

et al. 2012

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE To evaluate accurate diagnosis and complication rates of percutaneous core needle biopsy (PCNB) with an automated gun for small lung nodules that are 10 mm or less in diameter. MATERIALS AND METHODSForty-two cases of small lung nodules with diameters ≤10 mm (mean diameter, 9 mm) that received a PCNB were included in this study. Imaging guidance was fluoroscopy in 30 cases and computed tomography (CT) in 12 cases. RESULTSAccurate diagnosis was achieved with the initial PCNB in 88.1% (37/42) of cases. Accurate diagnosis rates were 86.7% (26/30) with fluoroscopic guidance and 91.7% (11/12) with CT guidance (P > 0.05). The complication rate of PCNB was 7.1% (3/42), including hemoptysis (n=2) and pneumothorax (n=1). The complication rate was 6.7% (2/30) with fluoroscopic guidance and 8.3% (1/12) with CT guidance (P > 0.05).CONCLUSION PCNB with an automated gun is useful for the pathologically conclusive diagnosis of small lung nodules (≤10 mm in diameter) using fluoroscopic or CT guidance. Key words: • X-ray computed tomography • fluoroscopy • lung diseases • biopsyP ercutaneous core needle biopsy (PCNB) of the lung is a well-established method for the cytological diagnosis of pulmonary nodules (1, 2). PCNB is generally regarded as a safe procedure with limited morbidity and extremely rare mortality (2-5). Biopsies of pulmonary lesions as small as 3 mm in diameter have been reported (6, 7). Diagnostic accuracy rates of 90%-100% using computed tomography (CT) guidance have been documented for pulmonary lesions greater than 10 mm in diameter (3,8). For smaller lesions, however, several studies have reported decreased diagnostic accuracy in the range of 52%-88% (3, 8, 9). Moreover, no study has reported a pathologically conclusive diagnosis of PCNB for small lung nodules using CT and fluoroscopy guidance.The purpose of this study was to evaluate the accurate diagnosis and complication rates of PCNB using an automated gun for small lung nodules with diameters <10 mm. Materials and methods PatientsBetween July 2004 and October 2011, 1467 consecutive percutaneous thoracic biopsies using automated biopsy devices or fine needle aspiration were performed at our institution. Of these cases, 81 extrapulmonary thoracic lesions, such as mediastinal (n=45), chest wall (n=21), and pleural (n=13) lesions were excluded. The remaining 1386 cases of PCNB were performed on pulmonary parenchymal lesions. The enrolled population consisted of 875 males (63.1%) and 511 females (36.9%). Patients' age ranged from 8 to 88 years (mean, 66.2 years). Using axial CT scan images, the largest transverse cross-sectional diameter of each nodule was measured on picture archiving and communication system workstations. The mean diameter of each nodule was considered as its size.Of the 1386 evaluable cases, there were 52 cases of initial PCNB and 10 cases of fine needle aspiration for small nodules with diameters <10 mm. Of these cases, 42 patients receiving an initial PCNB were enrolled in this study. The enrolled group consisted...

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Section: Volume 18 • Issuesupporting

confidence: 76%

mentioning

confidence: 99%

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Percutaneous core needle biopsy for small lung nodules with diameters ≤ 10 mm: accurate diagnosis and complication rates

Jae

June²,

Yie³

et al. 2012

Diagn Interv Radiol

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“…These findings are consistent with those of Yeow et al (6) Although Wallace et al (14) reported that small lesions that are 10 mm or less had a high diagnostic accuracy rate, most other studies showed a significant increase in diagnostic yield as the lesion size increased (5,19). Our study results confirm that CT guided TNAB had a high diagnostic yield for malignant lesions.…”

Section: Discussionsupporting

confidence: 83%

“…These findings suggest that if lesions are suspected to be benign, and the results of the TNAB are nonspecific with an adequate specimen, the lesion can be followed at regular intervals as suggested previously (19,23).…”

Section: Discussionmentioning

confidence: 95%

Inconclusive Result from CT Guided Transthoracic Needle Aspiration and Biopsy: Affecting Factors and Final Outcome

et al. 2011

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Purpose:Inconclusive results from com puted tom ography (CT)-guided transthoracic needle aspiration and biopsy (TNAB) performed for lung lesions presents a clinical dilem m a. The purpose of this study was to determ ine the factors affecting an inconclusive result from a CT guided TNAB, and to evaluate the final outcomes of these inconclusive results. Materials and Methods: The m edical records and radiologic features of 331 patients with lung lesion who received CT guided TNAB were analyzed retrospectively. The results of the TNAB were classified as conclusive (m alignancy or specific benign diagnosis) or inconclusive (nonspecific benign or nondiagnostic). Results: Of the 331 cases, 269 (81.3%) were diagnosed as a malignancy (210) or a specific benign lesion (59) after the first TNAB. The rem aining 62 (18.7% ) were inconclusive. Benign disease, a lesion size ≤15 mm, and morphology of the consolidation type were features significantly correlated with inconclusive results. Of these 62 inconclusive cases a second TNAB was perform ed in 23, and conclusive diagnoses were obtained in 19 (82.6%). Surgery or radiographic follow up was done in other cases. Finally, among the 62 inconclusive results on the first CT guided TNAB, 16 lesions were diagnosed as malignant, 26 were classified as specific benign disease, and the remaining 20 were defined as nonspecific inflam mation. Age over 50 and morphology of a nodule or a mass type were significantly correlated with a malignancy in these 62 cases with inconclusive results on the first TNAB. Conclusion: A final diagnosis of benign disease was significantly higher after the CT guided TNAB was inconclusive for lesions ≤15 mm that had consolidation type m orphology. Despite the application of core biopsy procedures, there continue to be appreciable num bers of inconclusive results after the first CT guided TNAB. A repeat CT guided TNAB had a high diagnostic yield in these cases and therefore should be considered for cases with inconclusive results. (J Lung Cancer 2011;10(2):94 101)

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Committee I: Indications for pulmonary cytology sampling methods

Michael

Hoda

Saqi

et al. 2016

Diagnostic Cytopathology

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The Papanicolaou Society of Cytopathology has developed a set of guidelines for pulmonary cytology including indications for bronchial brushings, washings and endobronchial ultrasound-guided fine needle aspiration, technical recommendations for cytologic sampling, recommended terminology and classification scheme, recommendations for ancillary testing and recommendations for postcytologic diagnosis management and follow-up. All recommendation documents are based on the expertise of the authors, extensive literature review and feedback from presentations at national and international conferences. This document selectively presents the results of these discussions. The present document summarizes the recommendations for clinical and imaging evaluation of pulmonary lesions along with the indications for cytologic studies regarding these abnormalities. Preprocedural requirements regarding brushing, washing and needle aspiration procedures are discussed also. Diagn. Cytopathol. 2016;44:1010-1023. © 2016 Wiley Periodicals, Inc.

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Percutaneous needle aspiration biopsy (PCNAB) of lung lesions: 5 years results with focusing on repeat PCNAB

Cited by 12 publications

References 16 publications

Percutaneous core needle biopsy for small lung nodules with diameters ≤ 10 mm: accurate diagnosis and complication rates

Percutaneous core needle biopsy for small lung nodules with diameters ≤ 10 mm: accurate diagnosis and complication rates

Inconclusive Result from CT Guided Transthoracic Needle Aspiration and Biopsy: Affecting Factors and Final Outcome

Committee I: Indications for pulmonary cytology sampling methods

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