Computed tomography-guided core needle biopsy for sub-centimeter pulmonary nodules
- PMID: 35891992
- PMCID: PMC9290407
- DOI: 10.5114/kitp.2022.117492
Computed tomography-guided core needle biopsy for sub-centimeter pulmonary nodules
Abstract
Introduction: Based on the computed tomography (CT) pulmonary nodules (PNs) screening trial, sub-centimeter PNs (SCPNs) with a diameter ≤ 10 mm are observed in approximately 15% of the screened population, of which 48-56% of the cases occur in patients with lung cancer.
Aim: To assess the safety and diagnostic precision of CT-guided core needle biopsy (CNB) for SCPNs.
Material and methods: Between January 2016 and December 2018, consecutive patients with PNs underwent a CT-guided CNB procedure. These patients were divided into 2 groups. Group A included patients with SCPNs and group B included patients with PNs of 11-20 mm in diameter. The baseline data, diagnostic performance, and complication rates were compared.
Results: The technical success rates of CT-guided CNB in groups A and B were both 100%. No statistically significant differences were observed in diagnostic yield (43.8% vs. 54.7%, p = 0.105), overall accuracy (89.5% vs. 94.0%, p = 0.221), and sensitivity (78.8% vs. 90.1%, p = 0.080) between the 2 groups. The independent risk factor related to diagnostic failure of SCPNs was CNB-related pneumothorax (p = 0.001). There were no significant differences in the rates of pneumothorax (13.3% vs. 15.4%, p = 0.664) and pulmonary hemorrhage (10.5% vs. 8.5%, p = 0.624) between the 2 groups. The risk factors related to pneumothorax were decubitus position (p = 0.009) and more needle pathways (p = 0.004). A risk factor associated with pulmonary hemorrhage was greater lesion-pleura distance (p = 0.048).
Conclusions: CT-guided CNB is a safe, reliable, and precise method for the diagnosis of SCPNs.
Keywords: biopsy; computed tomography; pulmonary nodule; sub-centimeter.
Copyright: © 2022 Polish Society of Cardiothoracic Surgeons (Polskie Towarzystwo KardioTorakochirurgów) and the editors of the Polish Journal of Cardio-Thoracic Surgery (Kardiochirurgia i Torakochirurgia Polska).
Conflict of interest statement
The authors report no conflict of interest.
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References
-
- MacMahon H, Naidich DP, Goo JM, Lee KS, Leung ANC, Mayo JR, Mehta AC, Ohno Y, Powell CA, Prokop M, Rubin GD, Schaefer-Prokop CM, Travis WD, Van Schil PE, Bankier AA. Guidelines for management of incidental pulmonary nodules detected on CT images: from the Fleischner Society 2017. Radiology 2017; 284: 228-43. - PubMed
-
- Winer-Muram HT. The solitary pulmonary nodule. Radiology 2006; 239: 34-49. - PubMed
-
- Xie Y, Zhang J, Xia Y. Semi-supervised adversarial model for benign-malignant lung nodule classification on chest CT. Med Image Anal 2019; 57: 237-48. - PubMed
-
- Zhang Y, Shen Y, Qiang JW, Ye JD, Zhang J, Zhao RY. HRCT features distinguishing pre-invasive from invasive pulmonary adenocarcinomas appearing as ground-glass nodules. Eur Radiol 2016; 26: 2921-8. - PubMed
-
- Zhang Y, Qiang JW, Ye JD, Ye XD, Zhang J. High resolution CT in differentiating minimally invasive component in early lung adenocarcinoma. Lung Cancer 2014; 84: 236-41. - PubMed
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