Darragh Halpenny1, Krishna Das2, Etay Ziv2, Andrew Plodkowski2, Junting Zheng3, Marinela Capanu3, Natasha Rekhtman4, Joseph Montecalvo4, Stephen B Solomon2, Michelle S Ginsberg2. 1. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States of America. Electronic address: halpennd@mskcc.org. 2. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States of America. 3. Department of Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States of America. 4. Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States of America.
Abstract
INTRODUCTION: This study assessed (i) the ability to identify the solid components of part-solid nodules (PSN) during computed tomography (CT) guided lung biopsy (CTGLB), (ii) the ability of CTGLB to assess the invasive nature of a nodule on pathology. MATERIALS AND METHODS: Sixty-nine nodules were studied in 68 patients who underwent CTGLB between 1/1/2014 and 10/31/2015. Diagnostic CT images and CTGLB images were reviewed. On diagnostic CT images, nodules were classified as ground glass nodules (GGN) or PSNs. Nodule size, location, and percentage of solid component were recorded. At the time of biopsy, the ability to visualize the solid component of a PSN, depth of lesion from skin, and ability to identify the needle within the solid component were recorded. RESULTS: There were 42 (61%) part-solid nodules and 27 (39%) GGNs. During biopsy, it was possible to differentiate the solid from the ground glass components in 35 (83%) PSNs. Fifty-nine (86%) nodules were neoplastic based on biopsy pathology (all non-small cell lung carcinoma). Thirty-nine (66%) were resected. In all cases biopsy pathology and surgical pathology agreed regarding the presence of lung carcinoma. In 6 (15%) cases biopsy pathology demonstrated purely lepidic growth but had some non-lepidic growth on surgical pathology, including 2 cases with acinar growth as a dominant pattern. CONCLUSION: In most patients, the solid and ground glass components of a PSN were distinguishable when performing a CTGLB. In a minority of patients, discrepancy was noted between biopsy pathology and surgical pathology regarding the invasive nature of a nodule.
INTRODUCTION: This study assessed (i) the ability to identify the solid components of part-solid nodules (PSN) during computed tomography (CT) guided lung biopsy (CTGLB), (ii) the ability of CTGLB to assess the invasive nature of a nodule on pathology. MATERIALS AND METHODS: Sixty-nine nodules were studied in 68 patients who underwent CTGLB between 1/1/2014 and 10/31/2015. Diagnostic CT images and CTGLB images were reviewed. On diagnostic CT images, nodules were classified as ground glass nodules (GGN) or PSNs. Nodule size, location, and percentage of solid component were recorded. At the time of biopsy, the ability to visualize the solid component of a PSN, depth of lesion from skin, and ability to identify the needle within the solid component were recorded. RESULTS: There were 42 (61%) part-solid nodules and 27 (39%) GGNs. During biopsy, it was possible to differentiate the solid from the ground glass components in 35 (83%) PSNs. Fifty-nine (86%) nodules were neoplastic based on biopsy pathology (all non-small cell lung carcinoma). Thirty-nine (66%) were resected. In all cases biopsy pathology and surgical pathology agreed regarding the presence of lung carcinoma. In 6 (15%) cases biopsy pathology demonstrated purely lepidic growth but had some non-lepidic growth on surgical pathology, including 2 cases with acinar growth as a dominant pattern. CONCLUSION: In most patients, the solid and ground glass components of a PSN were distinguishable when performing a CTGLB. In a minority of patients, discrepancy was noted between biopsy pathology and surgical pathology regarding the invasive nature of a nodule.
Authors: William D Travis; Elisabeth Brambilla; Masayuki Noguchi; Andrew G Nicholson; Kim R Geisinger; Yasushi Yatabe; David G Beer; Charles A Powell; Gregory J Riely; Paul E Van Schil; Kavita Garg; John H M Austin; Hisao Asamura; Valerie W Rusch; Fred R Hirsch; Giorgio Scagliotti; Tetsuya Mitsudomi; Rudolf M Huber; Yuichi Ishikawa; James Jett; Montserrat Sanchez-Cespedes; Jean-Paul Sculier; Takashi Takahashi; Masahiro Tsuboi; Johan Vansteenkiste; Ignacio Wistuba; Pan-Chyr Yang; Denise Aberle; Christian Brambilla; Douglas Flieder; Wilbur Franklin; Adi Gazdar; Michael Gould; Philip Hasleton; Douglas Henderson; Bruce Johnson; David Johnson; Keith Kerr; Keiko Kuriyama; Jin Soo Lee; Vincent A Miller; Iver Petersen; Victor Roggli; Rafael Rosell; Nagahiro Saijo; Erik Thunnissen; Ming Tsao; David Yankelewitz Journal: J Thorac Oncol Date: 2011-02 Impact factor: 15.609
Authors: Claudia I Henschke; David F Yankelevitz; Rosna Mirtcheva; Georgeann McGuinness; Dorothy McCauley; Olli S Miettinen Journal: AJR Am J Roentgenol Date: 2002-05 Impact factor: 3.959