Diagnostic yield, accuracy, and complication rate of CT-guided biopsy for spinal lesions: a systematic review and meta-analysis

2021 ◽  
pp. neurintsurg-2021-017419
Author(s):  
Giorgos D Michalopoulos ◽  
Yagiz Ugur Yolcu ◽  
Abdul Karim Ghaith ◽  
Mohammed Ali Alvi ◽  
Carrie M Carr ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Complication Rate ◽  
Diagnostic Performance ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Ct Guided ◽  
Spinal Lesions ◽  
Guided Biopsy ◽  
Ct Guided Biopsy

BackgroundCT-guided biopsy is a commonly used diagnostic procedure for spinal lesions. This meta-analysis aims to investigate its diagnostic performance and complications, as well as factors influencing outcomes.MethodsA systematic review of the literature was performed to identify studies reporting outcomes of CT-guided biopsies for spinal lesions. Diagnostic yield (ie, the rate of procedures resulting in a specific pathological diagnosis) and diagnostic accuracy (ie, the rate of procedures resulting in the correct diagnosis) were the primary outcomes of interest. Complications following biopsy procedures were also included.ResultsThirty-nine studies with 3917 patients undergoing 4181 procedures were included. Diagnostic yield per procedure was 91% (95% CI 88% to 94%) among 3598 procedures. The most common reason for non-diagnostic biopsies was inadequacy of sample. No difference in diagnostic yield between different locations and between lytic, sclerotic, and mixed lesions was found. Diagnostic yield did not differ between procedures using ≤13G and ≥14G needles. Diagnostic accuracy per procedure was 86% (95% CI 82% to 89%) among 3054 procedures. Diagnostic accuracy among 2426 procedures that yielded a diagnosis was 94% (95% CI 92% to 96%). Complication rate was 1% (95% CI 0.4% to 1.9%) among 3357 procedures. Transient pain and minor hematoma were the most common complications encountered.ConclusionIn our meta-analysis of 39 studies reporting diagnostic performance and complications of CT-guided biopsy, we found a diagnostic yield of 91% and diagnostic accuracy of 86% with a complication rate of 1%. Diagnostic yield did not differ between different locations, between lytic, sclerotic and mixed lesions, and between wide- and thin-bore needles.

Diagnostic Yield and Safety of Image-Guided Pleural Biopsy: A Systematic Review and Meta-Analysis

Respiration ◽  
2020 ◽  
pp. 1-11
Author(s):  
Federico Mei ◽  
Martina Bonifazi ◽  
Matteo Rota ◽  
Laura Cirilli ◽  
Martina Grilli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Selection Criteria ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Pleural Biopsy ◽  
Ultrasound Technique ◽  
Ct Guided ◽  
Guided Biopsy ◽  
Ct Guided Biopsy ◽  
Over Time

<b><i>Background:</i></b> Diagnostic yield (DY) and safety of computed tomography (CT)- and thoracic ultrasound (TUS)-guided biopsies in the diagnosis of pleural lesions have been investigated in a number of studies, but no synthesis of data from the literature has ever been performed. <b><i>Objectives:</i></b> We aimed to provide the first systematic review and meta-analysis on the DY and safety of CT- versus TUS-guided biopsy in the diagnosis of pleural lesions. <b><i>Method:</i></b> We searched MEDLINE and EMBASE for all studies reporting outcomes of interest published up to April 2018. Two authors reviewed all titles/abstracts and retrieved selected full text to identify studies according to predefined selection criteria. Summary estimates were derived using the random-effects model. Cumulative meta-analysis assessed the influence of increasing adoption of the procedures over time. <b><i>Results:</i></b> Thirty original studies were included in the present review; the number of studies on TUS-guided biopsy was almost three-fold higher than those on CT-guided biopsy. The pooled DYs of the 2 procedures were overall excellent and differed &#x3c;10%, being 84% for TUS-guided biopsy and 93% for CT-guided biopsy. Safety profiles were reassuring for both the techniques, being 7 and 3% for CT- and TUS-guided biopsy, respectively. DY of ultrasound technique significantly improved over time, while no time effect was observed for CT-guided biopsy. <b><i>Conclusions:</i></b> Data show that CT- and TUS-guided biopsies in the diagnosis of pleural lesions are both excellent procedures, without meaningful differences in DYs and safety. Considering that TUS is non-ionizing and easily performed at the bedside, it should be the preferred approach in presence of adequate skills.

scholarly journals Initial Experience in CT-Guided Percutaneous Transthoracic Needle Biopsy of Lung Lesions Performed by a Pulmonologist

2019 ◽  
Vol 8 (6) ◽  
pp. 821 ◽  
Author(s):  
June Hong Ahn ◽  
Jong Geol Jang
Keyword(s):  
Diagnostic Accuracy ◽  
Complication Rate ◽  
Predictive Value ◽  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Safe Procedure ◽  
Transthoracic Needle Biopsy ◽  
Ct Guided ◽  
Lung Lesions ◽  
Percutaneous Transthoracic Needle Biopsy

In the diagnosis of lung lesions, computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) has a high diagnostic yield and a low complication rate. The procedure is usually performed by interventional radiologists, but the diagnostic yield and safety of CT-guided PTNB when performed by pulmonologists have not been evaluated. A retrospective study of 239 patients who underwent CT-guided PTNB at Yeungnam University Hospital between March 2017 and April 2018 was conducted. A pulmonologist performed the procedure using a co-axial technique with a 20-gauge needle. Then diagnostic yield and safety were assessed. The overall sensitivity, specificity, positive predictive value, and negative predictive value for the diagnosis of malignancy were 96.1% (171/178), 100% (46/46), 100% (171/171), and 86.8% (46/53), respectively. The diagnostic accuracy was 96.9% (217/224) and the overall complication rate was 33.1% (82/248). Pneumothorax, hemoptysis, and hemothorax occurred in 27.0% (67/248), 5.2% (13/248), and 0.8% (2/248) of the patients, respectively. Univariate analyses revealed that pneumothorax requiring chest tube insertion was a significant risk factor (odds ratio, 25.0; p < 0.001) for diagnostic failure. CT-guided PTNB is a safe procedure with a high diagnostic accuracy, even when performed by an inexperienced pulmonologist. The results were similar to those achieved by interventional radiologists as reported in previously published studies.

Cross-cultural dementia screening using the Rowland Universal Dementia Assessment Scale: a systematic review and meta-analysis

2020 ◽  
Vol 32 (9) ◽  
pp. 1031-1044
Author(s):  
T. R. Nielsen ◽  
Kasper Jørgensen
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Diagnostic Performance ◽  
Formal Education ◽  
Meta Analysis ◽  
Assessment Scale ◽  
Screening Instruments ◽  
Middle Income ◽  
Brief Screening

ABSTRACTObjectives:To quantitatively synthesize data on the accuracy of the Rowland Universal Dementia Assessment Scale (RUDAS) in different sociocultural settings and compare its performance to other brief screening instruments for the detection of dementia.Design:Systematic review and meta-analysis. Literature searches were performed in PubMed, EMBASE, and CINAHL from January 1, 2004 until September 1, 2019.Setting:Community, outpatient clinic, and hospital settings in high-, and low- and middle-income countries.Participants:Twenty-six studies reporting diagnostic accuracy of the RUDAS were included with almost 4000 participants, including approximately 1700 patients with dementia.Measurements:Procedures for translation and cultural adaption of the RUDAS, and influence of demographic variables on diagnostic accuracy, were compared across studies. Bivariate random-effects models were used to pool sensitivity and specificity results, and diagnostic odds-ratios and the area under the hierarchical summary receiver operator characteristic curve were used to present the overall performance.Results:The pooled sensitivity and specificity for the detection of dementia were .82 (95% CI, .78–.86) and .83 (95% CI, .78–.87), respectively, with an area under the curve of .89. Subgroup analyses revealed that the RUDAS had comparable diagnostic performances across high-, and low- and middle-income settings (z = .63, P = .53) and in samples with a lower and higher proportion of participants with no formal education (z = −.15, P = .88). In 11 studies making direct comparison, the diagnostic performance of the RUDAS was comparable to that of the Mini-Mental State Examination (z = −.82, P = .41), with areas under the curve of .88 and .84, respectively.Conclusions:The RUDAS has good diagnostic performance for detecting dementia in different sociocultural settings. Compared to other brief screening instruments, advantages of the RUDAS include its limited bias in people with limited or no formal education and a minimal need for cultural or language adaptation.

scholarly journals Diagnostic Performance of Artificial Intelligence-Centred Systems in the Diagnosis and Postoperative Surveillance of Upper Gastrointestinal Malignancies Using Computed Tomography Imaging: A Systematic Review and Meta-Analysis of Diagnostic Accuracy

2021 ◽  
Author(s):  
Swathikan Chidambaram ◽  
Viknesh Sounderajah ◽  
Nick Maynard ◽  
Sheraz R. Markar
Keyword(s):  
Artificial Intelligence ◽  
Gastric Cancer ◽  
Systematic Review ◽  
Esophageal Cancer ◽  
Diagnostic Accuracy ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Diagnostic Methods ◽  
Gastrointestinal Malignancies ◽  
Upper Gastrointestinal

Abstract Background Upper gastrointestinal cancers are aggressive malignancies with poor prognosis, even following multimodality therapy. As such, they require timely and accurate diagnostic and surveillance strategies; however, such radiological workflows necessitate considerable expertise and resource to maintain. In order to lessen the workload upon already stretched health systems, there has been increasing focus on the development and use of artificial intelligence (AI)-centred diagnostic systems. This systematic review summarizes the clinical applicability and diagnostic performance of AI-centred systems in the diagnosis and surveillance of esophagogastric cancers. Methods A systematic review was performed using the MEDLINE, EMBASE, Cochrane Review, and Scopus databases. Articles on the use of AI and radiomics for the diagnosis and surveillance of patients with esophageal cancer were evaluated, and quality assessment of studies was performed using the QUADAS-2 tool. A meta-analysis was performed to assess the diagnostic accuracy of sequencing methodologies. Results Thirty-six studies that described the use of AI were included in the qualitative synthesis and six studies involving 1352 patients were included in the quantitative analysis. Of these six studies, four studies assessed the utility of AI in gastric cancer diagnosis, one study assessed its utility for diagnosing esophageal cancer, and one study assessed its utility for surveillance. The pooled sensitivity and specificity were 73.4% (64.6–80.7) and 89.7% (82.7–94.1), respectively. Conclusions AI systems have shown promise in diagnosing and monitoring esophageal and gastric cancer, particularly when combined with existing diagnostic methods. Further work is needed to further develop systems of greater accuracy and greater consideration of the clinical workflows that they aim to integrate within.

scholarly journals Conventional Autopsy versus Minimally Invasive Autopsy with Postmortem MRI, CT, and CT-guided Biopsy: Comparison of Diagnostic Performance

Radiology ◽  
2018 ◽  
Vol 289 (3) ◽  
pp. 658-667 ◽  
Author(s):  
Britt M. Blokker ◽  
Annick C. Weustink ◽  
Ivo M. Wagensveld ◽  
Jan H. von der Thüsen ◽  
Andrea Pezzato ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Diagnostic Performance ◽  
Ct Guided ◽  
Postmortem Mri ◽  
Guided Biopsy ◽  
Conventional Autopsy ◽  
Minimally Invasive Autopsy ◽  
Ct Guided Biopsy

Diagnostic yield and safety of percutaneous CT-guided biopsy of retroperitoneal lesions and analysis of imaging features

2021 ◽  
pp. 028418512199028
Author(s):  
Anil Kumar Singh ◽  
Zafar Neyaz ◽  
Ritu Verma ◽  
Anshul Gupta ◽  
Richa Mishra ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Final Diagnosis ◽  
Microbiological Analysis ◽  
Imaging Features ◽  
Imaging Findings ◽  
Chi Square ◽  
Tissue Samples ◽  
Ct Guided ◽  
Guided Biopsy ◽  
Ct Guided Biopsy

Background Computed tomography (CT)-guided biopsy is emerging as a preferred method for obtaining tissue samples from retroperitoneal lesions due to clear visualization of needle and vessels. Purpose To assess diagnostic yield and safety of CT-guided biopsy of retroperitoneal lesions and compare CT findings in different disease categories. Material and Methods This retrospective analytical study included 86 patients with retroperitoneal lesions who underwent CT-guided biopsy from December 2010 to March 2020. All procedures were performed with co-axial technique and multiple cores were obtained and subjected to histopathology. Additional tests like immunohistochemistry or microbiological analysis were done depending on clinical suspicion. Diagnostic yield calculation and comparison of imaging findings was done by one-way ANOVA, chi-square, and Fisher’s exact tests. Results CT-guided biopsy was technically successful in all cases with a diagnostic yield of 91.9%. Minor complications in the form of small hematomas were seen in two patients. Major disease categories on final diagnosis were lymphoma, tuberculosis, and metastases. A variety of malignant and benign soft-tissue neoplasms were also noted less commonly. With help of immunohistochemistry, lymphoma subtype was established in 88.8% of cases. Addition of microbiological tests like the GeneXpert assay helped in the diagnosis of tuberculosis in some cases. A mass-like appearance and vascular encasement was common in metastatic group and lymphoma. Conclusion Percutaneous CT-guided biopsy is a safe method for the sampling of retroperitoneal lesions with high diagnostic yield. Imaging findings are mostly overlapping; however, some features are more common in a particular disease condition.

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