Radiological-pathological correlation of negative CT biopsy results enables high negative predictive value for thoracic malignancy.
Clin Radiol
; 76(1): 77.e9-77.e15, 2021 01.
Article
in En
| MEDLINE
| ID: mdl-33059852
ABSTRACT
AIM:
To evaluate multidisciplinary team (MDT) practice of radiological-pathological correlation of non-malignant biopsy results to examine the additive effect on the predictive values of computed tomography (CT) biopsy for malignancy and their subsequent management and outcomes. MATERIALS ANDMETHODS:
A service evaluation of the MDT management of non-malignant lung biopsy results (May 2014- May 2017) was undertaken.RESULTS:
Sixty patients had a non-malignant diagnosis on initial CT biopsy. Five patients were lost to follow-up leaving 55 in the final cohort. Forty-eight of the 55 patients had biopsy results classified as potentially non-specific, of which 26 were classified as concordant with radiology (e.g., organising pneumonia with compatible CT features), and 22 were classified as discordant (e.g., non-specific inflammation and yet sufficiently suspicious CT features). Patients with concordant negative pathology showed resolution (n=19) or stability (n=6) on imaging follow-up. One lesion demonstrated growth and was proven malignant on surgical resection. Discordant lesions were managed with repeat biopsy (n=8) or surgical resection (n=13), with 12 final benign diagnoses and nine malignancies. The negative predictive value of CT biopsy alone was 44/55 (80%), following repeat biopsy was 44/50 (88%), and following radiological-pathological assessment was 32/33 (97%). No patients underwent a shift in stage from time of biopsy to resection.CONCLUSION:
Combining radiological-pathological interpretation of negative biopsy results offers superior negative predictive value for lung malignancy without delayed diagnosis of lung cancer.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tomography, X-Ray Computed
/
Image-Guided Biopsy
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Lung Neoplasms
Type of study:
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
/
Middle aged
Language:
En
Journal:
Clin Radiol
Year:
2021
Document type:
Article