Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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CT-Guided Core Needle Biopsy of Pleural Lesions: Evaluating Diagnostic Yield and Associated Complications

  • Niu, Xiang-Ke (Department of Radiology, Affiliated Hospital of Chengdu University) ;
  • Bhetuwal, Anup (Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College) ;
  • Yang, Han-Feng (Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College)
  • Received : 2014.05.01
  • Accepted : 2014.11.05
  • Published : 2015.02.01
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Abstract

Objective: The purpose of this study was to retrospectively evaluate the diagnostic accuracy and complications of CTguided 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 [${\pm}$ standard deviation] age, $51.1{\pm}14.4$ 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.

Keywords

References

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