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Accuracy of CT-guided transthoracic needle biopsy of lung lesions: Factors affecting diagnostic yield

Biopsia transtoracica percutanea TC-guidata di lesioni polmonari: variabili che influenzano l’accuratezza diagnostica

  • Chest Radiology Radiologia Toracica
  • Published:
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Abstract

Purpose

This study was performed to analyse the variables affecting the diagnostic accuracy of computed tomography (CT)-guided transthoracic needle biopsy of pulmonary lesions.

Materials and methods

A retrospective study of 612 consecutive procedures with confirmed final diagnoses was undertaken. Benign and malignant needle biopsy results were compared with final outcomes to determine diagnostic accuracy. A statistical analysis of factors related to patient characteristics, lung lesions and biopsy technique was performed to determine possible influences on diagnostic yield. A p value less than 0.05 was interpreted as statistically significant.

Results

There were 508 (83%) malignant and 104 (17%) benign lesions. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy for a diagnosis of malignancy were 90.2%, 99.0%, 99.8%, 67.3% and 91.7%, respectively. Overall diagnostic accuracy was 83.3%. Variables affecting diagnostic accuracy were the final diagnosis (benign 67%, malignant 92%; p<0.001) and lesion size (lesions<1.5 cm 68%, lesions 1.5–5.0 cm 87%, lesions>5 cm 78%; p<0.05).

Conclusions

In CT-guided transthoracic needle biopsy, the final diagnosis and lesion size affect diagnostic accuracy: benign lung lesions and lesions smaller than 1.5 cm or larger than 5.0 cm in diameter provide lower diagnostic yield.

Riassunto

Obiettivo

Valutare i fattori che influenzano l’accuratezza diagnostica dell’agobiopsia transtoracica percutanea TC-guidata di lesioni polmonari.

Materiali e metodi

Sono state considerate retrospettivamente 612 procedure bioptiche consecutive per le quali è risultata disponibile la diagnosi definitiva. I reperti bioptici benigni e maligni sono stati confrontati con la diagnosi finale, ricavando l’accuratezza diagnostica della metodica. È stata quindi condotta un’analisi statistica relativamente a variabili proprie del paziente, della lesione e della tecnica bioptica per determinare possibili influenze sui valori di accuratezza. I dati ottenuti sono stati considerati statisticamente significativi per valori di p<0,05.

Risultati

Cinquecentootto lesioni (83%) sono risultate, alla diagnosi finale, maligne, mentre 104 (17%) benigne. I valori di sensibilità, specificità, valore predittivo positivo, valore predittivo negativo ed accuratezza, riferiti ad una diagnosi di malignità, sono risultati rispettivamente del 90,2%, 99,0%, 99,8%, 67,3% e 91,7%. L’accuratezza diagnostica globale della procedura è stata dell’83,3%. Le variabili che hanno influenzato significativamente i livelli di accuratezza sono risultate la diagnosi finale (espansi benigni 67%, maligni 92%; p<0,001) ed il diametro medio della lesione (lesioni<1,5 cm 68%, tra 1,5 e 5,0 cm 87%, >5 cm 78%; p<0,005).

Conclusioni

La diagnosi finale (benignità versus malignità) e le dimensioni della lesione influenzano l’accuratezza diagnostica della metodica: addensamenti polmonari di natura benigna e lesioni con diametro <1,5 cm o >5 cm sono caratterizzati da livelli minori di accuratezza diagnostica.

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Authors and Affiliations

  1. Radiologia Diagnostica, Università degli Studi di Torino, A.S.O. San Luigi Gonzaga, Regione Gonzole 10, 10043, Orbassano (TO), Italy

    A. M. Priola, S. M. Priola, A. Cataldi & C. Fava

  2. Chirurgia Toracica, Università degli Studi di Torino, A.S.O. San Luigi Gonzaga, Regione Gonzole 10, 10043, Orbassano (TO), Italy

    L. Errico

  3. Farmacia, Università degli Studi di Torino, A.S.O. San Luigi Gonzaga, Regione Gonzole 10, 10043, Orbassano (TO), Italy

    M. Di Franco

  4. Anatomia Patologica, Università degli Studi di Torino, A.S.O. San Luigi Gonzaga, Regione Gonzole 10, 10043, Orbassano (TO), Italy

    V. Marci

  5. Oncologia Polmonare, Università degli Studi di Torino, A.S.O. San Luigi Gonzaga, Regione Gonzole 10, 10043, Orbassano (TO), Italy

    S. Novello

  6. Anatomia Patologica, Università degli Studi di Torino, A.S.O. San Giovanni Battista, Torino, Italy

    P. Campisi & L. Molinaro

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  1. A. M. Priola
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Correspondence to A. M. Priola.

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Priola, A.M., Priola, S.M., Cataldi, A. et al. Accuracy of CT-guided transthoracic needle biopsy of lung lesions: Factors affecting diagnostic yield. Radiol med 112, 1142–1159 (2007). https://doi.org/10.1007/s11547-007-0212-y

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  • DOI: https://doi.org/10.1007/s11547-007-0212-y

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