CT-guided thoracic biopsy:Evaluating diagnostic yield and complications

Stanley Ek Loh, Donald Df Wu, Sudhakar K. Venkatesh, Cheng Kang Ong, Eugene Liu, Kar Yin Seto, Anil Gopinathan, Lenny Ka Tan

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

Introduction: This study retrospectively evaluated CT-guided thoracic biopsies for diagnostic yield, accuracy and complications. Materials and Methods: A retrospective analysis of 384 patients (mean age 62.7 years; male/female = 251/133) who underwent 399 CT-guided thoracic biopsies were performed for evaluating diagnostic yield, accuracy and complications. Correlations between patients age, procedure factors (biopsy-needle size, number of passes, lesion-size, lesion-depth and traversed lung-length) and complications such as pneumothorax, haemothorax and haemoptysis were evaluated. A comparison between fi ne needle aspiration (FNA) group and core ± FNA group for diagnostic yield and complications was also performed. Results: FNA was performed in 349 patients and core ± FNA in 50 patients. The biopsy samples were adequate in 91.9% and the diagnostic accuracy for malignant lesions was 96.8% with 95.7% sensitivity and 100% specifi city. Pneumothorax (detected on CT) occurred in 139 cases (34.8%) and only 12 (3.0%) required insertion of an intercostal drain. Mild haemoptysis occurred in 13 patients (3.2%) and small haemothoraces in 2 patients. Pneumothorax occurrence was signifi cantly associated with the traversed lung-length (>3mm), lesion-size (≤33 mm) and lesion-depth (≥60mm) (P <0.05). Haemoptysis occurrence was also signifi cantly associated with traversed lunglength (>3mm) and lesion-size (≤33 mm) (P <0.05). There was no signifi cant difference between diagnostic yield and complication rate between FNA and core ± FNA groups. Conclusion: CT-guided thoracic biopsy is a safe procedure with high diagnostic yield and low risk of signifi cant complications. Traversed lung-length and smaller lesion size are associated with occurrence of pneumothorax and haemoptysis.

Original languageEnglish (US)
Pages (from-to)285-290
Number of pages6
JournalAnnals of the Academy of Medicine Singapore
Volume42
Issue number6
StatePublished - Jun 1 2013

Keywords

  • Accuracy
  • Complications
  • Diagnostic yield
  • Haemoptysis
  • Pneumothorax

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Loh, S. E., Wu, D. D., Venkatesh, S. K., Ong, C. K., Liu, E., Seto, K. Y., Gopinathan, A., & Tan, L. K. (2013). CT-guided thoracic biopsy:Evaluating diagnostic yield and complications. Annals of the Academy of Medicine Singapore, 42(6), 285-290.