Literature DB >> 27005931

Transthoracic Computed Tomography-Guided Lung Nodule Biopsy: Comparison of Core Needle and Fine Needle Aspiration Techniques.

Bippan S Sangha1, Cameron J Hague2, Jennifer Jessup2, Robert O'Connor3, John R Mayo2.   

Abstract

PURPOSE: To determine if there is a statistically significant difference in the computed tomography (CT)-guided trans-thoracic needle biopsy diagnostic rate, complication rate, and degree of pathologist confidence in diagnosis between core needle biopsy (CNB) and fine needle aspiration biopsy (FNAB).
METHODS: A retrospective cohort design was used to compare the diagnostic biopsy rate, diagnostic confidence, and biopsy-related complications of pneumothorax, chest tube placement, pulmonary hemorrhage, hemoptysis, admission to hospital, and length of stay between 251 transthoracic needle biopsies obtained via CNB (126) or FNAB (125). Complication rates were assessed using imaging and clinical follow-up. Final diagnosis was confirmed via surgical pathology or clinical follow-up over a period of up to 10 years.
RESULTS: CNB provided diagnostic samples in 91% and FNA in 80% of biopsies, which was statistically significant (P < .05). The sensitivities for CNB and FNAB were 89% (85 of 95) and 95% (84 of 88), respectively. The specificity of CNB was 100% (21 of 21) and for FNAB was 81% (2 of 11) with 2 false positives in the FNAB group. The differences in complication rate was not statistically significant for pneumothorax (50% vs 46%; determined by routine postbiopsy CT), chest tube (2% vs 4%), hemoptysis (4% vs 6%), and pulmonary hemorrhage (38% vs 47%) between FNAB and CNB, respectively. Seven patients requiring chest tube were admitted to hospital, 2 in the FNAB cohort for an average of 2.5 days and 5 in the CNB cohort for an average of 4.6 days.
CONCLUSIONS: CNB provided more diagnostic samples with no statistical difference in complication rate.
Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Entities:  

Keywords:  Core needle biopsy; Fine needle aspiration biopsy; Lung nodule; Transthoracic lung nodule biopsy

Mesh:

Year:  2016        PMID: 27005931     DOI: 10.1016/j.carj.2015.10.005

Source DB:  PubMed          Journal:  Can Assoc Radiol J        ISSN: 0846-5371            Impact factor:   2.248


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