Diagnostic and Interventional Radiology
Interventional Radiology - Original Article

Diagnostic accuracy and complication rates of percutaneous CT-guided coaxial needle biopsy of pulmonary lesions

1.

Clinic for Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina

2.

Department of Pathology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina

3.

Department of Radiology, Hacettepe University, Ankara, Turkey

Diagn Interv Radiol 2021; 27: 553-557
DOI: 10.5152/dir.2021.20844
Read: 165 Downloads: 32 Published: 01 February 2021

PURPOSE 
The aim of this retrospective study was to evaluate and compare diagnostic accuracy and complication rates of percutaneous computed tomography (CT)-guided biopsies of pulmonary lesions 10–35 mm, 35–50 mm, and >50 mm, using the coaxial biopsy technique. 

METHODS
Over a 4-year period, 235 lung biopsies were performed using the coaxial biopsy technique with 18G semi-automated true-cut needle. There were 163 (69.4%) male and 72 (30.6%) female patients, with a mean age of 64.01±9.18 years (18–85 years). The mean lesion size was 59.6±29.3 mm. The lesions were stratified into three groups according to size: lesions <35 mm (n=42, 17.9%), lesions 35–50 mm (n=53, 22.5%), and lesions >50 mm (n=140, 59.6%). Diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for all biopsies, and for each group separately, as well as the incidence of complications.

RESULTS
The overall diagnostic accuracy was 95.4%, with 95.52% sensitivity, 100% specificity, 100% PPV, and 47.37% NPV. For lesions <35 mm, diagnostic accuracy, sensitivity, and PPV were 100%. The lowest diagnostic accuracy was 93.9% in lesions >50 mm, with 93.65% sensitivity, 100% specificity, 100% PPV, and 42.86% NPV. An adequate sample was obtained in 219 core biopsies (93.2%), while 16 biopsies (6.8%) were nondiagnostic due to necrosis (4.25%) and insufficient biopsy material (2.55%). The most frequent complication was minor pneumothorax, which was seen at a rate of 19.1%; pneumothorax requiring chest tube placement occurred in 3 patients (1.3%). 

CONCLUSION
Diagnostic accuracy decreased with increasing lesion size. On the other hand, complication rates were higher in smaller lesions, more distanced from the pleura.

You may cite this article as: Sarajlic V, Vesnic S, Udovicic-Gagula D, Kuric H, Akhan O. Diagnostic accuracy and complication rates of percutaneous CT-guided coaxial needle biopsy of pulmonary lesions. Diagn Interv Radiol 2021; 27:553-557

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