Abstract No. 446 - Diagnostic yield of CT-guided percutaneous core biopsy of groundglass pulmonary lesions

Abstract

PurposeThe purpose of the study is to determine the sensitivity, specificity and accuracy of CT-guided percutaneous core biopsy of groundglass pulmonary lesions.Materials and MethodsA retrospective review of 1873 consecutive CT-guided lung biopsies at our institution between January 1, 2008 and January 31, 2014 was performed. 77 cases (4%) of groundglass pulmonary lesion biopsy were identified and selected for further review. The average patient age was 77 years and 42% of the patients had a previous diagnosis of lung cancer. Pathologic diagnosis from the core biopsy and any subsequent surgical pathology data were recorded. The cases were also reviewed for complications including pneumothorax and hemorrhage.Results51 (66%) of the biopsied lesions were positive for malignancy, 17 (22%) demonstrated benign pathology, 6 (8%) were suspicious for malignancy, and 3 (4%) were non-diagnostic. 28 of the patients with biopsies positive for malignancy subsequently underwent surgical resection with surgical pathology concordant in all cases. There was 1 false negative biopsy, proven to be malignancy following surgical resection. The overall diagnostic yield was 96%. The sensitivity of biopsy was 96% in cases confirmed with surgical pathology. 3 patients (4%) developed pneumothorax requiring chest tube placement. All 23 patients with core biopsy positive for malignancy who did not undergo surgical resection were treated with external beam radiation therapy.ConclusionCT-guided percutaneous biopsy is high yield for ground-glass pulmonary lesions, with high diagnostic accuracy and low complication rate. PurposeThe purpose of the study is to determine the sensitivity, specificity and accuracy of CT-guided percutaneous core biopsy of groundglass pulmonary lesions. The purpose of the study is to determine the sensitivity, specificity and accuracy of CT-guided percutaneous core biopsy of groundglass pulmonary lesions. Materials and MethodsA retrospective review of 1873 consecutive CT-guided lung biopsies at our institution between January 1, 2008 and January 31, 2014 was performed. 77 cases (4%) of groundglass pulmonary lesion biopsy were identified and selected for further review. The average patient age was 77 years and 42% of the patients had a previous diagnosis of lung cancer. Pathologic diagnosis from the core biopsy and any subsequent surgical pathology data were recorded. The cases were also reviewed for complications including pneumothorax and hemorrhage. A retrospective review of 1873 consecutive CT-guided lung biopsies at our institution between January 1, 2008 and January 31, 2014 was performed. 77 cases (4%) of groundglass pulmonary lesion biopsy were identified and selected for further review. The average patient age was 77 years and 42% of the patients had a previous diagnosis of lung cancer. Pathologic diagnosis from the core biopsy and any subsequent surgical pathology data were recorded. The cases were also reviewed for complications including pneumothorax and hemorrhage. Results51 (66%) of the biopsied lesions were positive for malignancy, 17 (22%) demonstrated benign pathology, 6 (8%) were suspicious for malignancy, and 3 (4%) were non-diagnostic. 28 of the patients with biopsies positive for malignancy subsequently underwent surgical resection with surgical pathology concordant in all cases. There was 1 false negative biopsy, proven to be malignancy following surgical resection. The overall diagnostic yield was 96%. The sensitivity of biopsy was 96% in cases confirmed with surgical pathology. 3 patients (4%) developed pneumothorax requiring chest tube placement. All 23 patients with core biopsy positive for malignancy who did not undergo surgical resection were treated with external beam radiation therapy. 51 (66%) of the biopsied lesions were positive for malignancy, 17 (22%) demonstrated benign pathology, 6 (8%) were suspicious for malignancy, and 3 (4%) were non-diagnostic. 28 of the patients with biopsies positive for malignancy subsequently underwent surgical resection with surgical pathology concordant in all cases. There was 1 false negative biopsy, proven to be malignancy following surgical resection. The overall diagnostic yield was 96%. The sensitivity of biopsy was 96% in cases confirmed with surgical pathology. 3 patients (4%) developed pneumothorax requiring chest tube placement. All 23 patients with core biopsy positive for malignancy who did not undergo surgical resection were treated with external beam radiation therapy. ConclusionCT-guided percutaneous biopsy is high yield for ground-glass pulmonary lesions, with high diagnostic accuracy and low complication rate. CT-guided percutaneous biopsy is high yield for ground-glass pulmonary lesions, with high diagnostic accuracy and low complication rate.