The diagnostic accuracy of CT-guided percutaneous core needle biopsy and fine needle aspiration in pulmonary lesions: a meta-analysis

Zhang, H.-F.; Zeng, Xian‐Tao; Xing, Fu-qi; Fan, Na; Liao, Meiyan

doi:10.1016/j.crad.2015.09.009

Cited by 46 publications

(39 citation statements)

References 36 publications

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“…It has been reported Original Article CT-guided transthoracic core needle biopsy for small pulmonary lesions: diagnostic performance and adequacy for molecular testing that the diagnostic accuracy of FNAB is decreased for small lesions (3,4). CT-guided transthoracic needle biopsy is a safe technology that is easy to operate, with a diagnostic accuracy for pulmonary lesions that reaches 64-97% (5)(6)(7)(8). Therefore, this procedure has become one of the major methods for determining the nature of pulmonary lesions.…”

Section: Introductionmentioning

confidence: 99%

CT-guided transthoracic core needle biopsy for small pulmonary lesions: diagnostic performance and adequacy for molecular testing

Tian¹,

Wang²,

Li³

et al. 2017

J. Thorac. Dis.

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Background: Computed tomography (CT)-guided transthoracic needle biopsy is a well-established, minimally invasive diagnostic tool for pulmonary lesions. Few large studies have been conducted on the diagnostic performance and adequacy for molecular testing of transthoracic core needle biopsy (TCNB) for small pulmonary lesions.Methods: This study included CT-guided TCNB with 18-gauge cutting needles in 560 consecutive patients with small (≤3 cm) pulmonary lesions from January 2012 to January 2015. There were 323 males and 237 females, aged 51.8±12.7 years. The size of the pulmonary lesions was 1.8±0.6 cm. The sensitivity, specificity, accuracy and complications of the biopsies were investigated. The risk factors of diagnostic failure were assessed using univariate and multivariate analyses. The sample's adequacy for molecular testing of non-small cell lung cancer (NSCLC) was analyzed.Results: The overall sensitivity, specificity, and accuracy for diagnosis of malignancy were 92.0% (311/338), 98.6% (219/222), and 94.6% (530/560), respectively. The incidence of bleeding complications was 22.9% (128/560), and the incidence of pneumothorax was 10.4% (58/560). Logistic multivariate regression analysis showed that the independent risk factors for diagnostic failure were a lesion size ≤1 cm [odds ratio (OR), 3.95; P=0.007], lower lobe lesions (OR, 2.83; P=0.001), and pneumothorax (OR, 1.98; P=0.004). Genetic analysis was successfully performed on 95.45% (168/176) of specimens diagnosed as NSCLC. At least 96.8% of samples with two or more passes from a lesion were sufficient for molecular testing. Conclusions:The diagnostic yield of small pulmonary lesions by CT-guided TCNB is high, and the procedure is relatively safe. A lesion size ≤1 cm, lower lobe lesions, and pneumothorax are independent risk factors for biopsy diagnostic failure. TCNB specimens could provide adequate tissues for molecular testing.

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Section: Introductionmentioning

confidence: 99%

CT-guided transthoracic core needle biopsy for small pulmonary lesions: diagnostic performance and adequacy for molecular testing

Tian¹,

Wang²,

Li³

et al. 2017

J. Thorac. Dis.

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“…Yao et al, in a review of 11 studies, showed that the sensitivities of CNB (85.7%‐97.4%) were higher overall than those of FNA (81.3%‐90.8%). A recently published meta‐analysis showed that lung FNA and CNB had similar diagnostic efficacies in pooled data from 21 studies; CNB (95%) had higher sensitivity than FNA (90%), but the 2 modalities had the same specificity (99%) . There are few published data on the diagnostic efficacy of combined FNA and CNB in the same patient.…”

Section: Discussionmentioning

confidence: 99%

“…Computed tomography (CT) image‐guided transthoracic needle biopsy, either fine‐needle aspiration (FNA) or core‐needle biopsy (CNB), is widely used in patients with a solitary lung nodule, primarily for diagnosis . CT‐guided transthoracic FNA biopsy has been proved to have high diagnostic efficacy and accuracy for malignancies in the lung …”

Section: Introductionmentioning

confidence: 99%

Diagnostic efficacy and molecular testing by combined fine‐needle aspiration and core needle biopsy in patients with a lung nodule

Chen

Gong

et al. 2020

Cancer Cytopathology

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Background Combined image‐guided fine‐needle aspiration biopsy (FNA) and core needle biopsy (CNB) has become the standard of care for diagnosis and/or molecular testing for patients with a solitary lung nodule at our institution. Our purpose was to evaluate the efficacy of this practice. Methods We identified patients who underwent combined lung FNA/CNB during 2012 at our institution. A total of 667 patients who underwent 682 combined lung FNA/CNB procedures were included in the study, including 355 men and 312 women. Combined lung FNA/CNB procedures were performed by a radiologist. The adequacy of FNA specimens was assessed immediately by a cytopathologist. The FNA and CNB specimens were interpreted separately by a cytopathologist and a surgical pathologist, respectively. The diagnostic accuracy of the combined technique was determined. Results The rate of diagnostic consistency between FNA and CNB was 83.4%, and the rate of diagnostic accuracy for malignancy was 98.5% for combined FNA/CNB. Combined FNA/CNB showed a high diagnostic efficacy for malignancy (sensitivity, 97.6%; specificity, 100%). Combined FNA/CNB had a lower false‐negative rate for malignancy (2.2%) than either FNA (7.2%) or CNB (6.2%) alone. FNA contributed to 10.3% of molecular analyses as a complementary tissue source. Conclusions Combined lung FNA/CNB has high diagnostic efficacy for malignancy and a lower false‐negative rate than either procedure alone. FNA was a valuable complement to CNB for molecular testing, potentially reducing patient inconvenience and morbidity associated with repeated lung needle biopsy.

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“…In this context, this technique has widespread acceptance as a preferred method of diagnosis, since it has already been demonstrated to be significantly accurate and safe [20][21][22][23][24]. The diagnostic yield of CT-guided transthoracic lung biopsy in nodules or masses has been reported to be as high as 95% [23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Yield of Computed Tomography-Guided Transthoracic Lung Biopsy in Diffuse Lung Diseases

et al. 2018

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Background: Accurate diagnosis is essential for successful management of diffuse lung disease (DLD). Histopathology may sometimes be necessary. Surgical lung biopsy, the gold standard, carries a risk of morbidity and mortality. Computed tomography (CT) guided transthoracic lung biopsy (CT-TLB) is a minimally invasive method for obtaining lung tissue. However, its diagnostic yield is unknown in DLD. Objective: To assess the diagnostic yield of CT-TLB in DLD according to the predominant high-resolution CT (HRCT) patterns. Methods: Between January 2009 and December 2016, we enrolled all consecutive adult patients with suspicion of DLD who underwent CT-guided transthoracic lung biopsy during the diagnostic work-up. All biopsies were performed by a senior interventional radiologist using CT fluoroscopy. Results: The study included 169 patients (50.3% men) with a mean (±SD) age of 58.3 ± 14 years. Consolidation was the predominant HRCT pattern. A definitive or probable diagnosis was made in 66.3%. The most frequent diagnosis was organizing pneumonia (36.2%). Diagnostic yield was higher when the predominant HRCT pattern was consolidation or nodular. The most common complication was pneumothorax (17.8%); other complications included mild hemoptysis (7.7%), hemothorax (1.2%), and death (0.59%). No acute exacerbation of the underlying condition was observed. Conclusions: CT-TLB proved to be accurate and safe for the diagnosis of DLD. The overall diagnostic yield of the procedure was 66.3%. Given its low complication rates, CT-TLB can be an option in patients whose respiratory function is seriously impaired and in those with substantial comorbidities, where more invasive procedures cannot be performed for reasons of safety.

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The diagnostic accuracy of CT-guided percutaneous core needle biopsy and fine needle aspiration in pulmonary lesions: a meta-analysis

Cited by 46 publications

References 36 publications

CT-guided transthoracic core needle biopsy for small pulmonary lesions: diagnostic performance and adequacy for molecular testing

CT-guided transthoracic core needle biopsy for small pulmonary lesions: diagnostic performance and adequacy for molecular testing

Diagnostic efficacy and molecular testing by combined fine‐needle aspiration and core needle biopsy in patients with a lung nodule

Diagnostic Yield of Computed Tomography-Guided Transthoracic Lung Biopsy in Diffuse Lung Diseases

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