CT-Guided Transthoracic Needle Aspiration Biopsy of Subsolid Lung Lesions

• DOI: 10.1016/j.jvir.2013.11.037
• Publication Date: 2014-02-25T15:47:32Z
• Authors: Aaron W.P. Maxwell; Jeffrey S. Klein; Kossivi Dantey; Sharon L. Mount; Kelly J. Butnor; Gladwyn Leiman
• Keywords: Aged, 80 and over; Image-Guided Biopsy; Male; Lung Neoplasms; Biopsy, Fine-Needle; Reproducibility of Results; Middle Aged; Radiography, Interventional; Sensitivity and Specificity; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Humans; Female; Tomography, X-Ray Computed; Aged

To assess the diagnostic performance of computed tomography (CT)-guided transthoracic needle aspiration biopsy (TNAB) in the evaluation of persistent subsolid lung lesions.A retrospective review of all CT-guided TNABs performed at a single institution from January 2002 to November 2012 was conducted to identify patients with persistent subsolid lung lesions. The diagnostic performance of CT-guided TNAB was assessed through comparison of cytologic diagnoses with core needle biopsy, surgical resection, or imaging and clinical follow-up. The cytologic, histologic, and imaging features of each lesion were characterized, and CT-guided TNAB complications were recorded.In 32 patients, a diagnosis of benign or malignant disease was identified through evaluation of pathologic or follow-up data. There were 18 men and 14 women, with a mean age of 67.1 years ± 9.6 (range, 52-86 y). The mean lesion diameter was 21 mm ± 11 (range, 8-62 mm). A final diagnosis of malignancy was made in 28 cases (87.5%); four benign lesions were also diagnosed. The overall sensitivity of CT-guided TNAB in the evaluation of these lesions was 89.2%, and the specificity and positive predictive value were 100%. Two pneumothoraces (6.3%) were identified.Among patients with subsolid lung lesions, CT-guided TNAB is safe and shows high sensitivity. The high specificity and positive predictive value of the procedure allow for definitive treatment decisions to be made for most patients.