CT fluoroscopy-guided core needle biopsy of anterior mediastinal masses

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Abstract

Objective: To retrospectively evaluate the safety, diagnostic yield, and risk factors of diagnostic failure of computed tomography (CT) fluoroscopy-guided biopsies of anterior mediastinal masses. Materials and methods: Biopsy procedures and results of anterior mediastinal masses in 71 patients (32 women/39 men; mean [± standard deviation] age, 53.8 ± 20.0 years; range, 14–88 years) were analyzed. Final diagnoses were based on surgical outcomes, imaging findings, or clinical follow-up findings. The biopsy results were compared with the final diagnosis, and the biopsy procedures grouped by pathologic findings into diagnostic success and failure groups. Multiple putative risk factors for diagnostic failure were then assessed. Results: Seventy-one biopsies (71 masses; mean size, 67.5 ± 27.3 mm; range 8.6–128.2 mm) were analyzed. We identified 17 grade 1 and one grade 2 adverse events (25.4% overall) according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Sixty-nine biopsies (97.2%) provided samples fit for pathologic analysis. Diagnostic failure was found for eight (11.3%) masses; the 63 masses diagnosed successfully included thymic carcinoma (n = 17), lung cancer (n = 14), thymoma (n = 12), malignant lymphoma (n = 11), germ cell tumor (n = 3), and others (n = 6). Using a thinner needle (i.e., a 20-gauge needle) was the sole significant risk factor for diagnostic failure (P = 0.039). Conclusion: CT fluoroscopy-guided biopsy of anterior mediastinal masses was safe and had a high diagnostic yield; however, using a thinner biopsy needle significantly increased the risk of a failed diagnosis.

Original languageEnglish
Pages (from-to)91-97
Number of pages7
JournalDiagnostic and interventional imaging
Volume99
Issue number2
DOIs
Publication statusPublished - Feb 1 2018

Fingerprint

Large-Core Needle Biopsy
Fluoroscopy
Tomography
Biopsy
Thymoma
Needles
National Cancer Institute (U.S.)
Germ Cell and Embryonal Neoplasms
Needle Biopsy
Terminology
Lymphoma
Lung Neoplasms
Safety

Keywords

  • Biopsy
  • Fluoroscopy
  • Mediastinal tumor
  • Tomography

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

@article{e4e519e6ea56430aaa9a0613cedd1cc8,
title = "CT fluoroscopy-guided core needle biopsy of anterior mediastinal masses",
abstract = "Objective: To retrospectively evaluate the safety, diagnostic yield, and risk factors of diagnostic failure of computed tomography (CT) fluoroscopy-guided biopsies of anterior mediastinal masses. Materials and methods: Biopsy procedures and results of anterior mediastinal masses in 71 patients (32 women/39 men; mean [± standard deviation] age, 53.8 ± 20.0 years; range, 14–88 years) were analyzed. Final diagnoses were based on surgical outcomes, imaging findings, or clinical follow-up findings. The biopsy results were compared with the final diagnosis, and the biopsy procedures grouped by pathologic findings into diagnostic success and failure groups. Multiple putative risk factors for diagnostic failure were then assessed. Results: Seventy-one biopsies (71 masses; mean size, 67.5 ± 27.3 mm; range 8.6–128.2 mm) were analyzed. We identified 17 grade 1 and one grade 2 adverse events (25.4{\%} overall) according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Sixty-nine biopsies (97.2{\%}) provided samples fit for pathologic analysis. Diagnostic failure was found for eight (11.3{\%}) masses; the 63 masses diagnosed successfully included thymic carcinoma (n = 17), lung cancer (n = 14), thymoma (n = 12), malignant lymphoma (n = 11), germ cell tumor (n = 3), and others (n = 6). Using a thinner needle (i.e., a 20-gauge needle) was the sole significant risk factor for diagnostic failure (P = 0.039). Conclusion: CT fluoroscopy-guided biopsy of anterior mediastinal masses was safe and had a high diagnostic yield; however, using a thinner biopsy needle significantly increased the risk of a failed diagnosis.",
keywords = "Biopsy, Fluoroscopy, Mediastinal tumor, Tomography",
author = "T. Iguchi and T. Hiraki and Y. Matsui and H. Fujiwara and J. Sakurai and Y. Masaoka and M. Uka and T. Tanaka and H. Gobara and S. Kanazawa",
year = "2018",
month = "2",
day = "1",
doi = "10.1016/j.diii.2017.10.007",
language = "English",
volume = "99",
pages = "91--97",
journal = "Diagnostic and interventional imaging",
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TY - JOUR

T1 - CT fluoroscopy-guided core needle biopsy of anterior mediastinal masses

AU - Iguchi, T.

AU - Hiraki, T.

AU - Matsui, Y.

AU - Fujiwara, H.

AU - Sakurai, J.

AU - Masaoka, Y.

AU - Uka, M.

AU - Tanaka, T.

AU - Gobara, H.

AU - Kanazawa, S.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Objective: To retrospectively evaluate the safety, diagnostic yield, and risk factors of diagnostic failure of computed tomography (CT) fluoroscopy-guided biopsies of anterior mediastinal masses. Materials and methods: Biopsy procedures and results of anterior mediastinal masses in 71 patients (32 women/39 men; mean [± standard deviation] age, 53.8 ± 20.0 years; range, 14–88 years) were analyzed. Final diagnoses were based on surgical outcomes, imaging findings, or clinical follow-up findings. The biopsy results were compared with the final diagnosis, and the biopsy procedures grouped by pathologic findings into diagnostic success and failure groups. Multiple putative risk factors for diagnostic failure were then assessed. Results: Seventy-one biopsies (71 masses; mean size, 67.5 ± 27.3 mm; range 8.6–128.2 mm) were analyzed. We identified 17 grade 1 and one grade 2 adverse events (25.4% overall) according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Sixty-nine biopsies (97.2%) provided samples fit for pathologic analysis. Diagnostic failure was found for eight (11.3%) masses; the 63 masses diagnosed successfully included thymic carcinoma (n = 17), lung cancer (n = 14), thymoma (n = 12), malignant lymphoma (n = 11), germ cell tumor (n = 3), and others (n = 6). Using a thinner needle (i.e., a 20-gauge needle) was the sole significant risk factor for diagnostic failure (P = 0.039). Conclusion: CT fluoroscopy-guided biopsy of anterior mediastinal masses was safe and had a high diagnostic yield; however, using a thinner biopsy needle significantly increased the risk of a failed diagnosis.

AB - Objective: To retrospectively evaluate the safety, diagnostic yield, and risk factors of diagnostic failure of computed tomography (CT) fluoroscopy-guided biopsies of anterior mediastinal masses. Materials and methods: Biopsy procedures and results of anterior mediastinal masses in 71 patients (32 women/39 men; mean [± standard deviation] age, 53.8 ± 20.0 years; range, 14–88 years) were analyzed. Final diagnoses were based on surgical outcomes, imaging findings, or clinical follow-up findings. The biopsy results were compared with the final diagnosis, and the biopsy procedures grouped by pathologic findings into diagnostic success and failure groups. Multiple putative risk factors for diagnostic failure were then assessed. Results: Seventy-one biopsies (71 masses; mean size, 67.5 ± 27.3 mm; range 8.6–128.2 mm) were analyzed. We identified 17 grade 1 and one grade 2 adverse events (25.4% overall) according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Sixty-nine biopsies (97.2%) provided samples fit for pathologic analysis. Diagnostic failure was found for eight (11.3%) masses; the 63 masses diagnosed successfully included thymic carcinoma (n = 17), lung cancer (n = 14), thymoma (n = 12), malignant lymphoma (n = 11), germ cell tumor (n = 3), and others (n = 6). Using a thinner needle (i.e., a 20-gauge needle) was the sole significant risk factor for diagnostic failure (P = 0.039). Conclusion: CT fluoroscopy-guided biopsy of anterior mediastinal masses was safe and had a high diagnostic yield; however, using a thinner biopsy needle significantly increased the risk of a failed diagnosis.

KW - Biopsy

KW - Fluoroscopy

KW - Mediastinal tumor

KW - Tomography

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U2 - 10.1016/j.diii.2017.10.007

DO - 10.1016/j.diii.2017.10.007

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