Abstract
Aim:
Pathologic sampling is essential for the diagnosis of peripheral lung tumors. In our study we examined a combination of CT-guided core-biopsies with rapid evaluation of imprint cytology with regard to diagnostic and cost efficiency.
Material and Methods:
Biopsy of a peripheral lung nodule was performed as core biopsy in local anesthesia under CT-guidance. Imprint cytology of the core biopsy specimen was used for rapid evaluation. The report times of the zytologic and histologic reports documented in the hospital information system were used for cost analysis.
Results:
91 patients received CT-guided biopsy for tumor diagnosis. In addition to core imprint cytology was performed for rapid evaluation biopsy in 58 cases. In 45/58 cases the cytological diagnosis was received in less than 60 minutes (mean 7:30h, median 48 min). The mean time to histological report was 52:30 h. The combination of core biopsy and imprint cytology enabled a correct diagnosis in all cases (11 benign nodules, 47 malignancies). In two cases the imprint cytology was false negative resulting in 96% sensitivity and 96,5% accuracy. There were 12 major complications: 11 chest tubes for pneumothorax, 1 bleeding requiring bronchoscopy.
The calculated costs for a core biopsy alone were documented with 54,30 Euro. The additional imprint cytology was calculated with another 21,07 Euro. The reduced time to diagnosis allowed for cost savings of 890 Euro.
Conclusion:
The combination of CT-guided core biopsy and imprint cytology enables a fast and very reliable tumor diagnosis and can save costs in the diagnostic work up of patients with peripheral lung nodules.
- © 2012 ERS
