EP1.05-11 Integrating Radiological Features to CT Guided Lung Biopsy Results; The Experience of an Argentinean University Teaching Hospital

Abstract

To analyze the radiological findings and the diagnostic accuracy of percutaneous transthoracic needle biopsies (CT- PTNB) performed for the evaluation of patients with lung lesions derived to our center. We describe a retrospective review of 206 consecutive patients undergoing CT- PTNB of lung lesions performed between 2016 and 2019 at a single oncological referral center. Clinico-pathological data, including: age, smoking status, and previous cancer was described. Radiologic lesion's characteristics on CT; multiple or solitary, location, mean diameter (mm), type (mass³30 mm, nodule <30mm, other), mean distance to pleura, presence of consolidation, nodule edge, calcifications, presence of radiologic emphysema, ground glass component and PET-CT SUVmax were used to compare with lung biopsy results. The rate and factors associated with complications was also be reported. From 105 patients who underwent CT- PTNB and fulfilled inclusion criteria; 85 (81%) had pathologic confirmed cancer diagnosis, 3 (3%) had benign findings and 17 (16%) had inadequate samples for accurate diagnosis. The majority of patients were: male (57%) and the mean age was 63 years (32–88). Lung cancer was the main diagnosis (49/85; 58%) achieved through CT-PTNB; 71.2% of these cases had adenocarcinoma histology and 29% (14/49) had previous cancer diagnosis (35%: breast cancer) being the majority of them smokers (86%). Metastatic lesions (36/85; 42%) were: 44% melanoma-sarcoma, 38%: breast, colorectal, renal and cervix cancer and 18%: lymphoma, cervix, head and neck, lung and urothelial cancer. Primary lung cancer compared to lung metastases showed on CT images: mass presentation (63%vs33%; p=0.002), right superior lobe localization (47% vs 33%; p=0,016), solitary lesion (77% vs 53%; p=0,016), consolidation (22% vs 5%; p=0,033), central calcification (12% vs 0%; p=0,024), emphysema (55% vs 28%; p=0,009), mean major diameter (mm) (61±33 vs 36±24; p=0,000), mean distance to pleura (mm)(32±78 vs 86±12.7; p=0,014) and PET-CT mean SUVmax (8.8±10.63 vs 4.7±6.8; p=0.045). The complication rate of CT- PTNB was 18.5% (half of them practiced through right upper lung lobe, being pneumothorax the most common. Mean distance between pleura to CT- PTNB site was 10.54 vs 3.81 mm in complicated and non-complicated cases, respectively. Primary and metastatic lung lesions were safely pathologically evaluated by CT- PTNB. Radiological characteristics of the lesions can help in patient's initial assessment to predict their nature.