Abstract
Background: Although conventional CT scan-guided needle biopsy is an established diagnostic method for pulmonary lesions, few large studies have been conducted on the diagnostic outcomes of CT fluoroscopy-guided lung biopsy. We have conducted a retrospective analysis to evaluate the diagnostic outcomes of 1,000 CT fluoroscopy-guided lung biopsies performed with 20-gauge coaxial cutting needles. Methods: We determined the diagnostic yield of CT fluoroscopy-guided lung biopsies performed with 20-gauge coaxial cutting needles for 1,000 lesions in 901 patients. Independent risk factors for diagnostic failure (ie, nondiagnostic, false-positive, and false-negative results) were determined with multivariate logistic regression analysis. Results: The biopsy results were nondiagnostic in 0.6% of the lesions (6 of 1,000 lesions). The sensitivity and specificity for the diagnosis of malignancy was 94.2% (741 of 787 lesions) and 99.1% (211 of 213 lesions), respectively; diagnostic accuracy was 95.2% (952 of 1,000 lesions). For lesions measuring ≤ 1.0 cm, the diagnostic accuracy was 92.7% (140 of 151 lesions). The significant independent risk factors for diagnostic failure were as follows: the acquisition of two or fewer specimens (odds ratio [OR], 2.43; p = 0.007), lesions in the lower lobe (OR, 2.50; p = 0.003), malignant lesions (OR, 7.16; p = 0.007), and lesions measuring ≤ 1.0 cm (OR, 3.85; p = 0.016) and ≥ 3.1 cm (OR, 4.32; p = 0.007). Conclusions: CT fluoroscopy-guided lung biopsy performed with 20-gauge coaxial cutting needles resulted in a high diagnostic yield, even in the case of small lesions. Factors such as the acquisition of two or fewer specimens, lesions in the lower lobe, malignant lesions, and lesions measuring ≤1.0 cm or ≥ 3.1 cm significantly increased the rate of diagnostic failure.
| Original language | English |
|---|---|
| Pages (from-to) | 1612-1617 |
| Number of pages | 6 |
| Journal | Chest |
| Volume | 136 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Dec 1 2009 |
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ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine
Cite this
CT fluoroscopy-guided biopsy of 1,000 pulmonary lesions performed with 20-gauge coaxial cutting needles : Diagnostic yield and risk factors for diagnostic failure. / Hiraki, Takao; Mimura, Hidefumi; Gobara, Hideo; Iguchi, Toshihiro; Fujiwara, Hiroyasu; Sakurai, Jun; Matsui, Yusuke; Inoue, Daisaku; Toyooka, Shinichi; Sano, Yoshifumi; Kanazawa, Susumu.
In: Chest, Vol. 136, No. 6, 01.12.2009, p. 1612-1617.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - CT fluoroscopy-guided biopsy of 1,000 pulmonary lesions performed with 20-gauge coaxial cutting needles
T2 - Diagnostic yield and risk factors for diagnostic failure
AU - Hiraki, Takao
AU - Mimura, Hidefumi
AU - Gobara, Hideo
AU - Iguchi, Toshihiro
AU - Fujiwara, Hiroyasu
AU - Sakurai, Jun
AU - Matsui, Yusuke
AU - Inoue, Daisaku
AU - Toyooka, Shinichi
AU - Sano, Yoshifumi
AU - Kanazawa, Susumu
PY - 2009/12/1
Y1 - 2009/12/1
N2 - Background: Although conventional CT scan-guided needle biopsy is an established diagnostic method for pulmonary lesions, few large studies have been conducted on the diagnostic outcomes of CT fluoroscopy-guided lung biopsy. We have conducted a retrospective analysis to evaluate the diagnostic outcomes of 1,000 CT fluoroscopy-guided lung biopsies performed with 20-gauge coaxial cutting needles. Methods: We determined the diagnostic yield of CT fluoroscopy-guided lung biopsies performed with 20-gauge coaxial cutting needles for 1,000 lesions in 901 patients. Independent risk factors for diagnostic failure (ie, nondiagnostic, false-positive, and false-negative results) were determined with multivariate logistic regression analysis. Results: The biopsy results were nondiagnostic in 0.6% of the lesions (6 of 1,000 lesions). The sensitivity and specificity for the diagnosis of malignancy was 94.2% (741 of 787 lesions) and 99.1% (211 of 213 lesions), respectively; diagnostic accuracy was 95.2% (952 of 1,000 lesions). For lesions measuring ≤ 1.0 cm, the diagnostic accuracy was 92.7% (140 of 151 lesions). The significant independent risk factors for diagnostic failure were as follows: the acquisition of two or fewer specimens (odds ratio [OR], 2.43; p = 0.007), lesions in the lower lobe (OR, 2.50; p = 0.003), malignant lesions (OR, 7.16; p = 0.007), and lesions measuring ≤ 1.0 cm (OR, 3.85; p = 0.016) and ≥ 3.1 cm (OR, 4.32; p = 0.007). Conclusions: CT fluoroscopy-guided lung biopsy performed with 20-gauge coaxial cutting needles resulted in a high diagnostic yield, even in the case of small lesions. Factors such as the acquisition of two or fewer specimens, lesions in the lower lobe, malignant lesions, and lesions measuring ≤1.0 cm or ≥ 3.1 cm significantly increased the rate of diagnostic failure.
AB - Background: Although conventional CT scan-guided needle biopsy is an established diagnostic method for pulmonary lesions, few large studies have been conducted on the diagnostic outcomes of CT fluoroscopy-guided lung biopsy. We have conducted a retrospective analysis to evaluate the diagnostic outcomes of 1,000 CT fluoroscopy-guided lung biopsies performed with 20-gauge coaxial cutting needles. Methods: We determined the diagnostic yield of CT fluoroscopy-guided lung biopsies performed with 20-gauge coaxial cutting needles for 1,000 lesions in 901 patients. Independent risk factors for diagnostic failure (ie, nondiagnostic, false-positive, and false-negative results) were determined with multivariate logistic regression analysis. Results: The biopsy results were nondiagnostic in 0.6% of the lesions (6 of 1,000 lesions). The sensitivity and specificity for the diagnosis of malignancy was 94.2% (741 of 787 lesions) and 99.1% (211 of 213 lesions), respectively; diagnostic accuracy was 95.2% (952 of 1,000 lesions). For lesions measuring ≤ 1.0 cm, the diagnostic accuracy was 92.7% (140 of 151 lesions). The significant independent risk factors for diagnostic failure were as follows: the acquisition of two or fewer specimens (odds ratio [OR], 2.43; p = 0.007), lesions in the lower lobe (OR, 2.50; p = 0.003), malignant lesions (OR, 7.16; p = 0.007), and lesions measuring ≤ 1.0 cm (OR, 3.85; p = 0.016) and ≥ 3.1 cm (OR, 4.32; p = 0.007). Conclusions: CT fluoroscopy-guided lung biopsy performed with 20-gauge coaxial cutting needles resulted in a high diagnostic yield, even in the case of small lesions. Factors such as the acquisition of two or fewer specimens, lesions in the lower lobe, malignant lesions, and lesions measuring ≤1.0 cm or ≥ 3.1 cm significantly increased the rate of diagnostic failure.
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U2 - 10.1378/chest.09-0370
DO - 10.1378/chest.09-0370
M3 - Article
C2 - 19429718
AN - SCOPUS:73149114866
VL - 136
SP - 1612
EP - 1617
JO - Chest
JF - Chest
SN - 0012-3692
IS - 6
ER -