CT-Guided Core Needle Biopsy of Pleural Lesions: Evaluating Diagnostic Yield and Associated Complications.
10.3348/kjr.2015.16.1.206
- Author:
Xiang Ke NIU
1
;
Anup BHETUWAL
;
Han Feng YANG
Author Information
1. Department of Radiology, Affiliated Hospital of Chengdu University, Chengdu, Sichuan Province 610000, China.
- Publication Type:Original Article
- Keywords:
CT-guided core needle biopsy;
Pleural biopsy;
Complication
- MeSH:
Adult;
Age Factors;
Aged;
Biopsy, Large-Core Needle/*adverse effects;
Female;
Humans;
Male;
Middle Aged;
Odds Ratio;
Pleural Effusion/*diagnosis/pathology;
Pneumothorax/*etiology;
Retrospective Studies;
Risk Factors;
Sensitivity and Specificity;
Sex Factors;
Tomography, X-Ray Computed;
Young Adult
- From:Korean Journal of Radiology
2015;16(1):206-212
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The purpose of this study was to retrospectively evaluate the diagnostic accuracy and complications of CT-guided core needle biopsy (CT-guided CNB) of pleural lesion and the possible effects of influencing factors. MATERIALS AND METHODS: From September 2007 to June 2013, 88 consecutive patients (60 men and 28 women; mean [+/- standard deviation] age, 51.1 +/- 14.4 years; range, 19-78 years) underwent CT-guided CNB, which was performed by two experienced chest radiologists in our medical center. Out of 88 cases, 56 (63%) were diagnosed as malignant, 28 (31%) as benign and 4 (5%) as indeterminate for CNB of pleural lesions. The final diagnosis was confirmed by either histopathological diagnosis or clinical follow-up. The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and complication rates were statistically evaluated. Influencing factors (patient age, sex, lesion size, pleural-puncture angle, patient position, pleural effusion, and number of pleural punctures) were assessed for their effect on accuracy of CT-guided CNB using univariate and subsequent multivariate analysis. RESULTS: Diagnostic accuracy, sensitivity, specificity, PPV, and NPV were 89.2%, 86.1%, 100%, 100%, and 67.8%, respectively. The influencing factors had no significant effect in altering diagnostic accuracy. As far as complications were concerned, occurrence of pneumothorax was observed in 14 (16%) out of 88 patients. Multivariate analysis revealed lesion size/pleural thickening as a significant risk factor (odds ratio [OR]: 8.744, p = 0.005) for occurrence of pneumothorax. Moreover, presence of pleural effusion was noted as a significant protective factor (OR: 0.171, p = 0.037) for pneumothorax. CONCLUSION: CT-guided CNB of pleural lesion is a safe procedure with high diagnostic yield and low risk of significant complications.
