A H Mahnken1. 1. Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum, Philipps-Universität Marburg, Baldingerstr., 35043, Marburg, Deutschland, mahnken@med.uni-marburg.de.
Abstract
CLINICAL/METHODICAL ISSUE: The management of solitary lung nodules poses a common clinical problem and biopsy is oftten required. Several guidelines provide slightly different recommendations and there are no uniform recommendations regarding the ideal technique of puncture guidance (e.g. percutaneous versus bronchoscopic or thoracoscopic). STANDARD RADIOLOGICAL METHODS: Fine needle aspiration biopsy (FNA) and core biopsy are well established techniques. Both can be performed under CT and to some extent ultrasound guidance. PERFORMANCE: Diagnostic accuracies of FNA and core biopsy for malignant lesions are around 95 %. Core biopsy is superior to FNA for establishing a specific diagnosis with a diagnostic yield of 81-88 % versus 17-21 %. ACHIEVEMENTS: In clinical routine practice core biopsy is the superior tool when compared to FNA. PRACTICAL RECOMMENDATIONS: Central lesions in close proximity to bronchi may be biopsied with endobronchial ultrasound (EBUS)-guided bronchoscopy. In all other lesions percutaneous, ideally CT-guided biopsy should be the method of first choice.
CLINICAL/METHODICAL ISSUE: The management of solitary lung nodules poses a common clinical problem and biopsy is oftten required. Several guidelines provide slightly different recommendations and there are no uniform recommendations regarding the ideal technique of puncture guidance (e.g. percutaneous versus bronchoscopic or thoracoscopic). STANDARD RADIOLOGICAL METHODS: Fine needle aspiration biopsy (FNA) and core biopsy are well established techniques. Both can be performed under CT and to some extent ultrasound guidance. PERFORMANCE: Diagnostic accuracies of FNA and core biopsy for malignant lesions are around 95 %. Core biopsy is superior to FNA for establishing a specific diagnosis with a diagnostic yield of 81-88 % versus 17-21 %. ACHIEVEMENTS: In clinical routine practice core biopsy is the superior tool when compared to FNA. PRACTICAL RECOMMENDATIONS: Central lesions in close proximity to bronchi may be biopsied with endobronchial ultrasound (EBUS)-guided bronchoscopy. In all other lesions percutaneous, ideally CT-guided biopsy should be the method of first choice.
Authors: Heber MacMahon; John H M Austin; Gordon Gamsu; Christian J Herold; James R Jett; David P Naidich; Edward F Patz; Stephen J Swensen Journal: Radiology Date: 2005-11 Impact factor: 11.105
Authors: Andrea Hayes-Jordan; Bairbre Connolly; Michael Temple; Peter Chait; Sheila Weitzman; Ike Njere; Jacob C Langer; Peter Kim Journal: J Pediatr Surg Date: 2003-05 Impact factor: 2.545