Computed tomography-guided percutaneous cutting needle biopsy for small (≤ 20 mm) lung nodules

Abstract Background: Computed tomography (CT)-guided cutting needle biopsy (CNB) has been widely used for the diagnosis of lung nodules (LNs). The false-negative rate of CT-guided lung biopsy is reported to be up to 16%. The aim of this study was to determine the predictors of true-negative results in LNs with CNB-based benign results. Methods: From January 2011 to December 2015, 96 patients with CNB-based non-specific benign results were included in this study as the training group to detect predictors of true-negative results. From January 2016 to December 2018, an additional 57 patients were included as a validation group to test the reliability of the predictors. Results: In the training group, a total of 96 patients underwent CT-guided CNB for 96 LNs. The CNB-based results were true-negatives for 82 LNs and false-negatives for 14 LNs. The negative predictive value of the CNB-based benign results was 85.4% (82/96). Univariate and multivariate logistic regression analyses revealed that CNB-based chronic inflammation with fibroplasias (P = 0.013, hazard ratio = 0.110, 95% confidential interval = 0.019–0.625) was the independent predictor of true-negative results. The area under the receiver operator characteristic (ROC) curve was 0.697 (P = 0.019). In the validation group, biopsy results for 47 patients were true-negative and 10 were false-negative. When the predictor was used on the validation group, the area under the ROC curve was 0.759 (P = 0.011). Conclusions: Most of the CNB-based benign results were true-negatives, and CNB-based chronic inflammation with fibroplasias could be considered a predictor of true-negative results.

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Computed tomography-guided biopsy of mediastinal lesions: fine versus cutting needles

Revista do Hospital das Clínicas ◽

10.1590/s0041-87812003000200003 ◽

2003 ◽

Vol 58 (2) ◽

pp. 69-74 ◽

Cited By ~ 17

Author(s):

André Piovesan de Farias ◽

Daniel Deheinzelin ◽

Riad N. Younes ◽

Rubens Chojniak

Keyword(s):

Computed Tomography ◽

Retrospective Study ◽

Needle Biopsy ◽

Fine Needle Biopsy ◽

Radiology Department ◽

Fine Needle ◽

Specific Diagnosis ◽

Image Guided ◽

Cutting Needle ◽

Initial Exploration

PURPOSE: To report the experience of a radiology department in the use of computed tomography guided biopsies of mediastinal lesions with fine and cutting needles, describing the differences between them. The results of adequacy of the sample and histologic diagnoses are presented according to the type of needle used. METHODS: We present a retrospective study of mediastinal biopsies guided by computed tomography performed from January 1993 to December 1999. Eighty-six patients underwent mediastinal biopsy in this period, 37 with cutting needles, 38 with fine needles, and 11 with both types (total of 97 biopsies). RESULTS: In most cases, it was possible to obtain an adequate sample (82.5%) and specific diagnosis (67.0%). Cutting-needle biopsy produced a higher percentage of adequate samples (89.6% versus 75.5%, P = 0.068) and of specific diagnosis (81.3% versus 53.1%, P = 0.003) than fine-needle biopsy. There were no complications that required intervention in either group. CONCLUSION: Because they are practical, safe, and can provide accurate diagnoses, image-guided biopsies should be considered the procedure of choice in the initial exploration of patients with mediastinal masses. In our experience, cutting needles gave higher quality samples and diagnostic rates. We recommend the use of cutting needles as the preferred procedure.

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Post-mortem computed tomography coaxial cutting needle biopsy to facilitate the detection of bacterioplankton using PCR probes as a diagnostic indicator for drowning

International Journal of Legal Medicine ◽

10.1007/s00414-016-1473-6 ◽

2016 ◽

Vol 131 (1) ◽

pp. 211-216 ◽

Cited By ~ 11

Author(s):

Guy N. Rutty ◽

Christopher Johnson ◽

Jasmin Amoroso ◽

Claire Robinson ◽

Carina J. Bradley ◽

...

Keyword(s):

Computed Tomography ◽

Needle Biopsy ◽

Post Mortem ◽

Diagnostic Indicator ◽

Cutting Needle

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Low-dose Computed Tomography-guided Core Needle Biopsy for Lung Nodules

Case Medical Research ◽

10.31525/ct1-nct04217655 ◽

2020 ◽

Author(s):

Keyword(s):

Computed Tomography ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Low Dose ◽

Lung Nodules ◽

Core Needle ◽

Low Dose Computed Tomography

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Computed tomography-guided cutting needle biopsy of pulmonary lesions

Revista do Hospital das Clínicas ◽

10.1590/s0041-87812002000100003 ◽

2002 ◽

Vol 57 (1) ◽

pp. 15-18 ◽

Cited By ~ 11

Author(s):

Liao Shin Yu ◽

Daniel Deheinzelin ◽

Riad N. Younes ◽

Rubens Chojniak

Keyword(s):

Computed Tomography ◽

Needle Biopsy ◽

Diagnostic Yield ◽

Pulmonary Nodules ◽

Thoracic Wall ◽

Radiology Department ◽

Histopathological Diagnosis ◽

Lung Lesions ◽

Malignant Lesions ◽

Cutting Needle

PURPOSE: To report the experience of a radiology department in the use of computed tomography - guided cutting needle biopsy of pulmonary nodules, by evaluating diagnostic yield and incidence of complications. METHODS: This is a retrospective analysis of 52 consecutive patients who underwent lung lesion biopsy guided by computed tomography, performed between May 1997 and May 2000. Thirty-five patients were male and 17 were female, with ages ranging from 5 to 85 years (median, 62 years). The size of the lesions ranged from 1.8 to 15 cm (median, 5.4 cm). RESULTS: In a total of 52 biopsies of lung lesions, 51 biopsies (98.1%) supplied appropriate material for histopathological diagnosis, with 9 diagnosed (17.3%) as benign and 42 (80.8%) as malignant lesions. Specific diagnosis was obtained in 44 (84.6%) biopsies: 4 benign (9.1%) and 40 (90.9%) malignant lesions. The sensitivity, specificity, and accuracy of the cutting needle biopsies for determining presence of malignancy were 96.8%, 100%, and 97.2%, respectively. Complications occurred in 9 cases (17.3%), including 6 cases (11.5%) of small pneumothorax, 1 (1.9%) of hemoptysis, 1 (1.9%) of pulmonary hematoma, and 1 (1.9%) of thoracic wall hematoma. All had spontaneous resolution. There were no complications requiring subsequent intervention. CONCLUSION: The high sensitivity and specificity of the method and the low rate of complications have established cutting needle biopsy as an efficient and safe tool for the diagnosis of lung lesions. In our hospital, cutting needle biopsy is considered a reliable procedure for the evaluation of indeterminate pulmonary nodules.

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Computed tomography guided needle biopsy: experience from 1,300 procedures

Sao Paulo Medical Journal ◽

10.1590/s1516-31802006000100003 ◽

2006 ◽

Vol 124 (1) ◽

pp. 10-14 ◽

Cited By ~ 51

Author(s):

Rubens Chojniak ◽

Rony Klaus Isberner ◽

Luciana Marinho Viana ◽

Liao Shin Yu ◽

Alessandro Amorim Aita ◽

...

Keyword(s):

Computed Tomography ◽

Needle Biopsy ◽

Needle Aspiration ◽

Metastatic Lesion ◽

Primary Malignancy ◽

Ct Guided ◽

Fine Needle ◽

Specific Diagnosis ◽

Thoracic Drainage ◽

Cutting Needle

CONTEXT AND OBJECTIVE: Computed tomography (CT) guided biopsy is widely accepted as effective and safe for diagnosis in many settings. Accuracy depends on target organ and needle type. Cutting needles present advantages over fine needles. This study presents experience from CT guided biopsies performed at an oncology center. DESIGN AND SETTING: Retrospective study at Hospital do Câncer A. C. Camargo, São Paulo. METHODS: 1,300 consecutive CT guided biopsies performed between July 1994 and February 2000 were analyzed. Nodules or masses were suspected as primary malignancy in 845 cases (65%) or metastatic lesion in 455 (35%). 628 lesions were thoracic, 281 abdominal, 208 retroperitoneal, 134 musculoskeletal and 49 head/neck. All biopsies were performed by one radiologist or under his supervision: 765 (59%) with 22-gauge fine-needle/aspiration technique and 535 (41%) with automated 16 or 18-gauge cutting-needle biopsy. RESULTS: Adequate samples were obtained in 70-92% of fine-needle and 93-100% of cutting-needle biopsies. The specific diagnosis rates were 54-67% for fine-needle and 82-100% for cutting-needle biopsies, according to biopsy site. For any site, sample adequacy and specific diagnosis rate were always better for cutting-needle biopsy. Among 530 lung biopsies, there were 84 pneumothorax (16%) and two hemothorax (0.3%) cases, with thoracic drainage in 24 (4.9%). Among abdominal and retroperitoneal biopsies, there were two cases of major bleeding and one of peritonitis. CONCLUSION: Both types of needle showed satisfactory results, but cutting-needle biopsy should be used when specific diagnosis is desired without greater incidence of complications.

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