CT-guided transthoracic fine-needle aspiration versus transbronchial fluoroscopy-guided needle aspiration in pulmonary nodules

1998 ◽  
Vol 39 (4) ◽  
pp. 395-399 ◽  
Author(s):  
S. Shankar ◽  
Madhu Gulati ◽  
D. Gupta ◽  
A. Rajwanshi ◽  
S. Suri
Keyword(s):  
Fine Needle Aspiration ◽  
Diagnostic Yield ◽  
Pulmonary Nodules ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Definitive Diagnosis ◽  
Ct Guided ◽  
Fine Needle ◽  
Group A ◽  
Made In

Purpose: To evaluate the diagnostic yield of CT-guided (CTNAB) and fluoroscopy-guided transbronchial (TBNA) fine-needle aspiration cytology in pulmonary nodules and to compare their complications. Material and Methods: Thirty patients with pulmonary nodules not abutting upon the chest wall and inaccessible to bronchoscopy were randomised for CTNAB or TBNA. Eighteen patients underwent CTNAB and 16 TBNA. Four patients underwent both procedures. Results: In the CTNAB group, a definitive diagnosis could be made in 14 (78%) out of 18 patients whereas in the TBNA group, a definitive diagnosis was made in 11 (69%) out of 16 patients. This difference was not statistically significant ( p>0.05). The final diagnosis in 29 out of 30 patients comprised primary bronchogenic carcinoma in 14 patients, metastases in 5 patients, and benign lesions in 10 patients (34%) of which 3 lesions (30%) were of tuberculous aetiology. There were 2 asymptomatic pneumothoraces in the CTNAB group and no complication was observed in the TBNA group. Conclusion: Both techniques were safe and effective in the diagnosis of peripheral pulmonary lesions. TBNA was best suited for lesions larger than 3 cm and located in the middle and lower lobes while CTNAB could be used for any lesions.

CT-Guided Fine-Needle Aspiration Cytology of Solitary Pulmonary Nodules*

CHEST Journal ◽  
1997 ◽  
Vol 112 (2) ◽  
pp. 423-425 ◽  
Author(s):  
Luigi Santambrogio ◽  
Mario Nosotti ◽  
Nadia Bellaviti ◽  
Gianni Pavoni ◽  
Ferdinando Radice ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Pulmonary Nodules ◽  
Needle Aspiration ◽  
Solitary Pulmonary Nodules ◽  
Aspiration Cytology ◽  
Ct Guided ◽  
Fine Needle ◽  
Needle Aspiration Cytology

Ct-guided transthoracic fine-needle aspiration versus transbronchial fluoroscopy-guided needle aspiration in pulmonary nodules

1998 ◽  
Vol 39 (4) ◽  
pp. 395-399 ◽  
Author(s):  
S. Shankar ◽  
Madhu Gulati ◽  
D. Gupta ◽  
A. Rajwanshi ◽  
S. Suri
Keyword(s):  
Fine Needle Aspiration ◽  
Pulmonary Nodules ◽  
Needle Aspiration ◽  
Ct Guided ◽  
Fine Needle

Diagnostic accuracy and complication rate of CT-guided fine needle aspiration biopsy of lung lesions: A study based on the experience of the cytopathologist

2010 ◽  
Vol 51 (5) ◽  
pp. 527-533 ◽  
Author(s):  
Adriano Massimiliano Priola ◽  
Sandro Massimo Priola ◽  
Aldo Cataldi ◽  
Marisa Di Franco ◽  
Francesco Pazè ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Fine Needle Aspiration ◽  
Complication Rate ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Ct Guided ◽  
Lung Lesions ◽  
Fine Needle ◽  
Group A ◽  
Group B

Background: CT-guided transthoracic needle biopsy is a well-established technique for the diagnosis of focal lung lesions. Fine needle aspiration biopsy (FNAB) requires the presence of a cytopathologist on-site to assess the adequacy of samples. For this reason FNAB is less and less used, and core biopsy is the first-line procedure when an experienced cytopathologist is not immediately available. Purpose: To evaluate the accuracy and complication rate of CT-guided FNAB of lung lesions according to the experience of the cytopathologist on-site. Material and Methods: A total of 321 consecutive biopsies were considered. Immediate cytological assessment was performed by an experienced cytopathologist for the first 165 procedures (group A) and by two training pathologists for the remaining 156 biopsies (group B). At the time of FNAB the pathologist assigned a semiquantitative score (0–3) to each specimen to assess its diagnostic quality. All variables between the two groups were analyzed by chi-square and Student's t test. A P value <0.05 was considered statistically significant. Results: For all procedures, overall diagnostic accuracy was 80% for cytology alone, with no statistical difference between the two groups for diagnostic accuracy and sample score assigned. In all, 75% of the cytological samples (75% group A, 74% group B) obtained a higher score with a specific diagnosis of histotype. A post biopsy pneumothorax was detected in 27% of biopsies (25% group A, 28% group B). Thirteen patients (4.0%) required chest tube insertion for treatment. For all cases, the pneumothorax rate was significantly affected by the number of samples obtained ( P=0.02), but not by the pleural punctures ( P=0.15). There was no statistically significant difference between the two groups concerning the number of needle passes and complication rate ( P>0.05). Conclusion: The efficacy and safety of CT-guided FNAB is not significantly affected by the training level of the cytopathologist on-site. Moreover, the number of specimens obtained for each procedure is a risk factor for pneumothorax.

scholarly journals Adequacy of Cytologic Samples by Ultrasound-Guided Percutaneous Transthoracic Fine-Needle Aspiration Cytology of Peripheral Pulmonary Nodules for Morphologic Diagnosis and Molecular Evaluations: Comparison With Computed Tomography–Guided Percutaneous Transthoracic Fine-Needle Aspiration Cytology

2019 ◽  
Vol 144 (3) ◽  
pp. 361-369 ◽  
Author(s):  
Immacolata Cozzolino ◽  
Andrea Ronchi ◽  
Gaetana Messina ◽  
Marco Montella ◽  
Floriana Morgillo ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Pulmonary Nodules ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Ct Guided ◽  
Fine Needle ◽  
The Mean ◽  
Needle Aspiration Cytology ◽  
Mean Time

Context.— Fine-needle aspiration cytology (FNAC) of pulmonary nodules is usually guided by computed tomography (CT), whereas ultrasonography (US) is generally considered not applicable for such purposes. Objective.— To evaluate the clinical applicability and diagnostic utility of US-guided transthoracic FNAC of peripheral pulmonary nodules. Design.— Ultrasonography-guided transthoracic FNAC was obtained from 40 selected patients with peripheral, subpleural, and paravertebral pulmonary nodules. Air-dried and Diff-Quik–stained smears were used for rapid on-site evaluation; additional smears were alcohol fixed for Papanicolaou staining. Cell blocks were set up for immunocytochemical and molecular studies; in 2 cases, a flow cytometry evaluation was also performed. The series was compared to 40 CT-guided pulmonary FNAC samples from patients with pleural, peripheral, and paravertebral pulmonary nodules, to evaluate differences in terms of diagnostic rate, time of execution, safety, and cost. Results.— The US-guided FNAC samples had results that were adequate and representative in 95% of cases. No significant differences were observed between the 2 groups in terms of diagnostic rate, number of passes, and cellularity of both smears and cell blocks. The mean time needed for the execution of US-guided FNAC was 13.1 minutes, whereas the mean time for CT-guided FNAC was 23.6 minutes. Thus, US-guided FNAC was significantly more rapid than CT-guided pulmonary FNAC. Because pneumothorax occurred in 1 individual who underwent US-guided FNAC and in 9 who underwent CT-guided FNAC, we might conclude that US-guided FNAC is a significantly safer procedure. Finally, comparing the costs of both procedures, US-guided FNAC is less expensive. Conclusions.— Our experience showed an elevated clinical applicability and diagnostic utility of US-guided transthoracic FNAC for selected pulmonary nodules.

scholarly journals Does Onsite Cytotechnology Evaluation Improve the Accuracy of Endoscopic Ultrasound-Guided Fine-Needle Aspiration Biopsy?

2009 ◽  
Vol 23 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Fahad Alsohaibani ◽  
Safwat Girgis ◽  
Gurpal Singh Sandha
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Diagnostic Yield ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Tissue Sampling ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Group I ◽  
Group Ii

BACKGROUND: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the preferred modality for the cytological diagnosis of various cancers. Onsite cytopathology interpretation is not available in most centres.OBJECTIVE: To assess whether the the adequacy of tissue sampling assessed by an onsite cytotechnologist improves the diagnostic accuracy of EUS-FNA.METHODS: The present study is a retrospective review of all patients undergoing solid mass EUS-FNA between September 2005 and August 2007. Patients in group I (September 2005 to August 2006) had cytology slides prepared by an endoscopy nurse. Patients in group II (September 2006 to August 2007) had cytology slides prepared, stained and assessed for adequacy of tissue sampling by a cytotechnologist in the endoscopy suite. The final cytopathological diagnosis (definitely positive, definitely negative or inconclusive) was compared between the two groups.RESULTS: A total of 49 EUS-FNA procedures were performed in 47 patients in group I and 60 EUS-FNA procedures in 55 patients in group II. Pancreatic masses were the most common target site in both groups. The total number of needle passes was 105 in group I (mean 2.14 passes per patient; range one to five needle passes) and 158 in group II (mean 2.63 passes per patient; range one to four needle passes). The difference in the number of needle passes was not statistically significant between groups. The final diagnosis was definite in 53% in group I compared with 77% in group II (P=0.01). The percentage of inconclusive diagnoses was 47% in group I and 23% in group II (P=0.001).CONCLUSION: Onsite cytotechnologist interpretation of adequacy of tissue sampling significantly improves the diagnostic yield of EUS-FNA. This appears to be independent of the total number of needle passes undertaken for tissue sampling.

Predictive factors of diagnostic accuracy of CT-guided transthoracic fine-needle aspiration for solid noncalcified, subsolid and mixed pulmonary nodules

2013 ◽  
Vol 118 (7) ◽  
pp. 1071-1081 ◽  
Author(s):  
Massimo De Filippo ◽  
Luca Saba ◽  
Giorgio Concari ◽  
Rita Nizzoli ◽  
Lilia Ferrari ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Factors ◽  
Fine Needle Aspiration ◽  
Pulmonary Nodules ◽  
Needle Aspiration ◽  
Ct Guided ◽  
Fine Needle

Value OF CT-Guided Fine Needle Aspiration in Solitary Pulmonary Nodules with Negative Fiberoptic Bronchoscopy

1994 ◽  
Vol 35 (5) ◽  
pp. 478-480 ◽  
Author(s):  
F. García Río ◽  
S. Díaz Lobato ◽  
J. M. Pino ◽  
M. Atienza ◽  
J. M. Viguer ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Pulmonary Hemorrhage ◽  
Fiberoptic Bronchoscopy ◽  
Pulmonary Nodules ◽  
Needle Aspiration ◽  
Response To Therapy ◽  
Solitary Pulmonary Nodules ◽  
Ct Guided ◽  
Fine Needle

The usefulness of fine needle aspiration (FNA) with CT-guidance was evaluated in the diagnosis of solitary pulmonary nodules (SPN) following negative fiberoptic bronchoscopy in 84 patients. The records were analyzed for all patients with SPN who had undergone chest FNA in the years 1988 to 1990, showing previous nondiagnostic fiberoptic bronchoscopy. A final diagnosis was made by biopsy (transbronchial, thoracotomy or necropsy), response to therapy or follow-up of the lesions. The patients had medium-sized lesions, 2.87 ± 1.11 cm, adherent to the pleura in 62%. In the diagnosis of malignancy FNA showed 76% sensitivity, 100% specificity, 100% positive predictive value, 52% negative predictive value and 81% accuracy. These results were correlated with histology in 84% of the cases. One pulmonary hemorrhage, which resolved spontaneously, and 12 cases of pneumothorax, requiring a thoracic tube in 4 patients, were noted.

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