CT assessment-based direct surgical resection of part-solid nodules with solid component larger than 5 mm without preoperative biopsy: experience at a single tertiary hospital.
Eur Radiol
; 27(12): 5119-5126, 2017 Dec.
Article
em En
| MEDLINE
| ID: mdl-28656460
ABSTRACT
OBJECTIVES:
To retrospectively evaluate the feasibility of CT assessment-based direct surgical resection of part-solid nodules (PSNs) with solid components > 5 mm without preoperative percutaneous transthoracic needle biopsies (PTNBs).METHODS:
From January 2009-December 2014, 85 PSNs with solid components > 5 mm on CT were included. Preoperative PTNBs were performed for 41 PSNs (biopsy group) and CT assessment-based direct resections were performed for 44 PSNs (direct surgery group). Diagnostic accuracy and complication rates of the groups were compared.RESULTS:
Pathological results of 83 PSNs excluding two indeterminate nodules included 76 adenocarcinomas (91.6%), two adenocarcinomas in situ (2.4%) and five benign lesions (6.0%). In the biopsy group, the overall sensitivity, specificity and accuracy for the diagnosis of adenocarcinoma were 78.9% (30/38), 100% (1/1) and 79.5% (31/39), respectively. Pneumothorax and haemoptysis occurred in 11 procedures (26.8%). In the direct surgery group, the respective values for the diagnosis of adenocarcinoma were 100% (38/38), 0% (0/6) and 86.4% (38/44), respectively. Seven pneumothoraces (15.9%); no haemoptysis occurred during localization procedures. There were no significant differences in diagnostic accuracy (P = 0.559) between the two groups.CONCLUSIONS:
CT assessment-based direct resection can be reasonable for PSNs with solid part > 5 mm. KEY POINTS ⢠91.6% of PSNs with solid component > 5 mm were adenocarcinomas. ⢠PTNBs for PSNs with solid component > 5 mm had 79.5% accuracy. ⢠CT-based resection for PSNs with solid component > 5 mm had 86.4% accuracy. ⢠CT-based resection without biopsy can be a reasonable option in routine practice.Palavras-chave
Texto completo:
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Adenocarcinoma
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Tomografia Computadorizada por Raios X
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Nódulo Pulmonar Solitário
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Neoplasias Pulmonares
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
Limite:
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
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Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article