Transthoracic lung biopsy for pulmonary nodules ≤20â
mm in routine clinical care.
ERJ Open Res
; 8(1)2022 Jan.
Article
em En
| MEDLINE
| ID: mdl-35083315
ABSTRACT
BACKGROUND:
Computed tomography (CT) screening has improved lung cancer survival, yet increasingly detects small lung lesions. Thus, the number of transthoracic lung biopsies (TTLB) for small nodules is expected to rise significantly. The aim of the present study was to evaluate the diagnostic accuracy and safety of CT-guided TTLB for nodules ≤20â mm versus nodules >20â mm. STUDY DESIGN ANDMETHODS:
Data for CT-guided TTLBs from 474 consecutive patients were prospectively collected over a 3-year period (198 lesions ≤20â mm and 276 lesions >20â mm) in a teaching hospital and analysed in terms of diagnostic performance and complications.RESULTS:
There were more conclusive biopsies in the >20â mm lesion group (n=236, 85.5%) than in ≤20â mm lesion group (n=140, 70.7%; p<0.001). The overall accuracy, sensitivity, specificity and negative predictive value for diagnosing malignant lesions after first TTLB were 88.4%, 84%, 100% and 70.1%, respectively, for ≤20â mm lesions, and 94.2%, 93%, 100% and 74.6%, respectively, for >20â mm lesions. Pneumothorax requiring drainage was significantly more common for ≤20â mm lesions, compared to TTLB of larger lesions (9.6% versus 4.3%; p=0.02). Prolonged hospital stay due to pneumothorax occurred in 27 (17.4%) TTLBs of ≤20â mm lesions and 15 (7%) TTLBs of >20â mm lesions (p=0.002). There were no deaths. The only variable significantly associated with diagnostic failure in the ≤20â mm lesion group was the radiologist's experience.INTERPRETATION:
TTLBs for lesions ≤20â mm were associated with slightly lower diagnostic performance, whereas the higher rate of major complications was still inferior to that extrapolated from United States insurance databases.
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1
Base de dados:
MEDLINE
Tipo de estudo:
Prognostic_studies
Idioma:
En
Revista:
ERJ Open Res
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
França