Panwen Tian1, Ye Wang1, Lei Li2, Yongzhao Zhou2, Wenxin Luo2, Weimin Li2. 1. Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China; Lung Cancer Treatment Center, West China Hospital, Sichuan University, Chengdu 610041, China. 2. Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
Abstract
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.
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.
Authors: Nour-Eldin A Nour-Eldin; Mohammed Alsubhi; Ahmed Emam; Thomas Lehnert; Martin Beeres; Volkmar Jacobi; Tatjana Gruber-Rouh; Jan-Erik Scholtz; Thomas J Vogl; Nagy N Naguib Journal: Cardiovasc Intervent Radiol Date: 2015-07-07 Impact factor: 2.740
Authors: Stephen B Solomon; Maureen F Zakowski; William Pao; Raymond H Thornton; Marc Ladanyi; Mark G Kris; Valerie W Rusch; Naiyer A Rizvi Journal: AJR Am J Roentgenol Date: 2010-01 Impact factor: 3.959
Authors: Jin Hur; Hye-Jeong Lee; Ji Eun Nam; Young Jin Kim; Tae Hoon Kim; Kyu Ok Choe; Byoung Wook Choi Journal: AJR Am J Roentgenol Date: 2009-03 Impact factor: 3.959
Authors: Emily B Tsai; Kelsey Pomykala; Kathleen Ruchalski; Scott Genshaft; Fereidoun Abtin; Antonio Gutierrez; Hyun J Kim; Alice Li; Carlos Adame; Ashkan Jalalian; Brian Wolf; Edward B Garon; Jonathan W Goldman; Robert Suh Journal: Radiology Date: 2017-12-12 Impact factor: 11.105
Authors: David Lang; Viktoria Reinelt; Andreas Horner; Kaveh Akbari; Franz Fellner; Petra Lichtenberger; Bernd Lamprecht Journal: Wien Klin Wochenschr Date: 2018-01-23 Impact factor: 1.704