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Wei YH, Zhou FX, Li Y, et al. Extrapleural locating method in computed tomography-guided needle biopsies of 1,106 lung lesions. Exp Ther Med. 2015;10(5):1707-1719doi: 10.3892/etm.2015.2735.
Wei, Y. H., Zhou, F. X., Li, Y., Zhou, Y. F., Anish, K., Xu, L. Y., & Liao, M. Y. (2015). Extrapleural locating method in computed tomography-guided needle biopsies of 1,106 lung lesions. Experimental and therapeutic medicine, 10(5), 1707-1719. https://doi.org/10.3892/etm.2015.2735
Wei, Yue-Hua, et al. "Extrapleural locating method in computed tomography-guided needle biopsies of 1,106 lung lesions." Experimental and therapeutic medicine vol. 10,5 (2015): 1707-1719. doi: https://doi.org/10.3892/etm.2015.2735
Wei YH, Zhou FX, Li Y, Zhou YF, Anish K, Xu LY, Liao MY. Extrapleural locating method in computed tomography-guided needle biopsies of 1,106 lung lesions. Exp Ther Med. 2015 Nov;10(5):1707-1719. doi: 10.3892/etm.2015.2735. Epub 2015 Sep 08. PMID: 26640541; PMCID: PMC4665221.
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Exp Ther Med. 2015 Nov;10(5):1707-1719. doi: 10.3892/etm.2015.2735. Epub 2015 Sep 08.

Extrapleural locating method in computed tomography-guided needle biopsies of 1,106 lung lesions.

Experimental and therapeutic medicine

Yue-Hua Wei, Fu-Xiang Zhou, Yan Li, Yun-Feng Zhou, Krishna Anish, Li-Ying Xu, Mei-Yan Liao

Affiliations

  1. Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China.
  2. Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China ; Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China.
  3. Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China ; Department of Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China.
  4. Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China.
  5. Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China ; Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China.

PMID: 26640541 PMCID: PMC4665221 DOI: 10.3892/etm.2015.2735

Abstract

Transthoracic needle biopsy is considered to be safe and effective for the diagnosis of focal lung lesions. The aim of the present study was to evaluate factors affecting the accuracy and safety of automated cutting needle lung biopsy (ACNB) using a new extrapleural locating (EPL) method. Computed tomography (CT)-guided needle biopsies were performed on 1,065 patients between March 2005 and May 2012 using the EPL method. The locating needle remained in the chest following extrapleural positioning, while the radiologist confirmed the puncture angle and distance between the locating needle and lesion. The biopsy instrument was advanced into the lung, and the core needle was subsequently fired into the lesion based on the direction indicated by the locating needle. Univariate and multivariate regression analyses were used to evaluate the diagnostic accuracy and safety of the procedure. The sensitivity, specificity, positive predictive value and negative predictive value of the extrapleural method were 91.9, 100, 100 and 82.9%, respectively, and the overall diagnostic accuracy was 94.2%. Significant risk factors affecting accuracy were younger age, atelectasis, hemoptysis and lesion depth (P<0.03). Multivariate logistic regression analysis revealed that the risk of malignant lesions receiving a false-negative diagnosis decreased for each additional year of subject age [odds ratio (OR), 0.97; P=0.027] and increased with each millimeter increase in lesion depth (OR, 1.03; P=0.008). Among the 1,106 lesions biopsied, 207 were associated with pneumothorax, 251 with hemorrhage and 58 with hemoptysis. Multivariate analysis revealed that lesion size and emphysema affected pneumothorax incidence, while age, lesion location and depth and emphysema significantly affected hemorrhage incidence (P<0.05). In conclusion, low-dose, CT-guided ACNB with the EPL method provides a safe and accurate diagnosis.

Keywords: atelectasis; biopsy; computed tomography scan; hemoptysis; pneumothorax

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