Percutaneous CT-guided lung biopsy for the diagnosis of persistent pulmonary consolidation - 01/11/20
Highlights |
• | Percutaneous CT-guided lung biopsy is an alternate diagnostic option after failed bronchoscopy for a definite diagnosis of persistent lung consolidation. |
• | Percutaneous CT-guided lung biopsy has excellent sensitivity and specificity for the diagnosis of persistent lung consolidation due to malignant condition. |
• | Percutaneous CT-guided lung biopsy conveys a low rate of complications, which are generally minor ones. |
Abstract |
Purpose |
The primary objective of this study was to determine the diagnostic accuracy of percutaneous computed tomography (CT)-guided biopsy of persistent pulmonary consolidations. The secondary objective was to determine the complication rate and identify factors affecting diagnostic yield.
Materials and methods |
Two radiologists retrospectively reviewed 98 percutaneous CT-guided biopsies performed in 93 patients (60 men, 33 women; mean age, 62±14.0 (SD) years; range: 18–88 years) with persistent pulmonary consolidations. Final diagnoses were based on surgical outcomes or 12 months clinical follow-up findings. Biopsy results were compared to the final diagnosis to estimate diagnostic yield.
Results |
A final diagnosis was obtained for all patients: 51/93 (54.8%) had malignant lesions, 12/93 (12.9%) specific definite benign lesions (including 9 infections, two pneumoconiosis and one lipoid pneumonia) and 30/93 (32.3%) non-specific benign lesions. CT-guided biopsy had an overall diagnostic yield of 60% (59/98) with a correct diagnosis for 50/51 malignant lesions (diagnostic yield of 98% for malignancy) and for 9/47 benign lesions (diagnostic yield of 19% for benign conditions). Major complications occurred in 4/98 (4%) of lung biopsies (four pneumothoraxes requiring chest tube placement).
Conclusion |
Percutaneous CT-guided biopsy is an alternative to endoscopic or surgical biopsy for the diagnosis of persistent consolidation with a low risk of severe complication.
Le texte complet de cet article est disponible en PDF.Keywords : Lung diseases, Pneumonia, Tomography, X-ray computed (CT), Image-guided biopsy
Plan
Vol 101 - N° 11
P. 727-732 - novembre 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.