Evolution of transthoracic fine needle aspiration and core needle biopsy practice: A comparison of two time periods, 1996-1998 and 2003-2005

Douglas M. Minot, Elizabeth Jaben, Marie Christine Aubry, Jesse S. Voss, Roanna L. Vine, Peter U. Lee, Stephanie K. Carlson, Amy C. Clayton

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

To examine the performance of our large pulmonary transthoracic fine needle aspiration/core biopsy (FNA/CB) practice over time, we performed a retrospective analysis of data from 333 consecutive procedures performed in 1996-1998 and 568 consecutive procedures performed in 2003-2005. Fluoroscopic guidance was performed more frequently in the earlier cohort, while a larger majority of procedures in the later cohort were by computed tomography (CT-guidance). A follow-up histologic diagnosis of cancer or clinical evidence of disease was considered the gold-standard. FNA/CB procedures during the later time period were performed on smaller lesions overall (3.60 cm versus 2.97 cm; P = 0.003) and malignant lesions also tended to be smaller (3.87 cm versus 3.14 cm; P = 0.006). Minimal improvements in sensitivity (94% versus 91%), specificity (99% versus 95%), diagnostic accuracy (95% versus 92%), negative predictive value (NPV) (80% versus 74%), and positive predictive value (PPV) (100% versus 99%) were noted during 2003-2005 when compared with 1996-1998 in all lesions. Larger improvements in sensitivity (94% versus 73%), diagnostic accuracy (95% versus 79%), and NPV (79% versus 50%) were identified in very small lesions (<1 cm) in the later patient cohort in comparison to the earlier patient cohort, as well as a significant decrease in total procedure complications. CT-guided transthoracic FNA/CB continues to be a very effective tool in our practice assessing lung lesions and performance has improved considerably at our institution for very small lesions. Diagn. Cytopathol. 2012.

Original languageEnglish (US)
Pages (from-to)876-881
Number of pages6
JournalDiagnostic cytopathology
Volume40
Issue number10
DOIs
StatePublished - Oct 1 2012

Keywords

  • X-ray computed
  • biopsy
  • cytology
  • fine-needle
  • fluoroscopy
  • intrathoracic lesions
  • tomography

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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