Publish in this journal
Journal Information
Vol. 55. Issue 6.
Pages 297-305 (June 2019)
Share
Share
Download PDF
More article options
ePub
Visits
0
Vol. 55. Issue 6.
Pages 297-305 (June 2019)
Original Article
DOI: 10.1016/j.arbr.2018.09.021
CT-guided Transthoracic Core-Needle Biopsies of Mediastinal and Lung Lesions in 235 Consecutive Patients: Factors Affecting the Risks of Complications and Occurrence of a Final Diagnosis of Malignancy
Biopsia transtorácica con aguja gruesa guiada por tc de lesiones mediastínicas y pulmonares en 235 pacientes consecutivos: factores que afectan al riesgo de complicaciones y al diagnóstico final de cáncer
Visits
0
Daniel Nicoletti Césara, Ulysses S. Torresb,
Corresponding author
, Giuseppe D’Ippolitob,c, Arthur Soares Souzaa
a Hospital de Base, Faculdade de Medicina de São José do Rio Preto, São Paulo, Brazil
b Grupo Fleury, São Paulo, Brazil
c Department of Imaging, Universidade Federal de São Paulo, São Paulo, Brazil
This item has received
0
Visits
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Tables (7)
Table 1. Patient demographics and lesion characteristics.
Table 2. Procedure-related characteristics and complications.
Table 3. Final diagnoses in all patients submitted to CT-guided transthoracic biopsies confirmed through clinico-radiological follow-up or surgery.
Table 4. Diagnostic accuracy of the 235 CT-guided transthoracic biopsies.
Table 5. Patient-related characteristics versus final diagnosis of malignancy after PCNB and complication rates.
Table 6. Lesion features and risk factors for malignancy.
Table 7. Lesion features and technical factors versus occurrence of complications.
Show moreShow less
Figures (1)
Abstract
Objective

To assess the impact of patient-, lesion- and procedure-related factors on the risks of complications and final diagnosis of malignancy in PCNB of mediastinal and lung lesions.

Material and Methods

We studied a large single-center cohort of 235 consecutive patients (66.8% men; 58.5±18.0 years) with a range of thoracic benign and malignant lesions, who underwent PCNB performed along 24 months by a single experienced radiologist. Diagnostic accuracy analyses of PCNB for malignancy were performed, as well as estimations of relative risk and logistic regression models in order to assess possible associations between such factors and malignancy/complications.

Results

155 lesions (65.9%) were diagnosed as malignant. Overall accuracy was 91.1%, with sensitivity of 87.1%, specificity of 98.8%, positive predictive value of 99.3%, and negative predictive value of 79.8%. Pneumothorax (49/235; 20.8%) and hemorrhage (37/235; 15.7%) were the most common complications. Emphysema, smoking, older age, intrapulmonary location, deeper location, smaller size, presence of cavitations and irregular contours of the lesions, and smaller needle-pleural angles were the most consistent factors related to the occurrence of complications. Emphysema, older age, smoking, solid and deeper lesions were also significantly associated with a final diagnosis of malignancy after PCNB.

Conclusion

CT-guided PCNB of mediastinal and lung lesions is a safe procedure with high diagnostic accuracy for malignancy.

Keywords:
CT
Mediastinum
Lung
Malignancy
Biopsy
Resumen
Objetivo

Evaluar el impacto de los factores relacionados con el paciente, la lesión y el procedimiento en el riesgo de complicaciones y que el diagnóstico final sea cáncer en la biopsia percutánea con aguja gruesa (B.A.G) de lesiones mediastínicas y pulmonares.

Materiales y métodos

Se estudió una cohorte unicéntrica grande de 235 pacientes consecutivos (66,8% hombres; 58,5±18,0 años) con diversas lesiones torácicas benignas y malignas, a los que un único radiólogo experimentado practicó B.A.G. a lo largo de 24 meses. Se realizaron análisis de precisión diagnóstica del B.A.G para el cáncer, así como estimaciones del riesgo relativo y modelos de regresión logística para evaluar las posibles asociaciones entre esos factores y diagnóstico de cáncer y/o aparición de complicaciones.

Resultados

Se determinó que 155 lesiones (65,9%) eran malignas. La precisión total fue del 91,1%, con una sensibilidad del 87,1%, una especificidad del 98,8%, un valor predictivo positivo del 99,3% y un valor predictivo negativo del 79,8%. Las complicaciones más frecuentes fueron el neumotórax (49/235; 20,8%) y la hemorragia (37/235; 15,7%). Los factores relacionados de forma más consistente con la existencia de complicaciones fueron el enfisema, el tabaquismo, la edad avanzada, la localización intrapulmonar, la localización profunda, el tamaño pequeño, la presencia de lesiones cavitadas con contornos irregulares y los ángulos aguja-pleura más pequeños. El enfisema, la edad avanzada, el tabaquismo y las lesiones sólidas y profundas también se asociaron significativamente con un diagnóstico final de cáncer después de la B.A.G.

Conclusión

La B.A.G guiada por TC de lesiones mediastínicas y pulmonares es un procedimiento seguro con una elevada precisión diagnóstica para la detección del cáncer.

Palabras clave:
TC
Mediastino
Pulmón
Cáncer
Biopsia

Article

These are the options to access the full texts of the publication Archivos de Bronconeumología (English Edition)
Member
If you are a member of SEPAR:
  • Go to >>>SEPAR<<< website and sign in.
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Archivos de Bronconeumología (English Edition)

Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Archivos de Bronconeumología (English Edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.