Fluoroscopy-Guided Percutaneous Transthoracic Biopsy: Comparison between Fine Needle Aspiration Biopsy and Core Biopsy with an Automated Cutting Needle

Abstract

Purpose: To compare the diagnostic accuracy and complication rates of fluoroscopyguided percutaneous transthoracic fine needle aspiration biopsy (FNAB) and core biopsy (CB). Materials and Methods: Ninety-one fluoroscopy-guided lung biopsies were performed in 86 patients using a 22-gauge fine needle (n=52) or a 21-gauge automated cutting needle (n=39). The size of pulmonary lesions were 1-9 cm. Histologic diagnosis rates and complications rates of the two groups were compared. Results: The overall sensitivity of FNAB was 98% (51/52) which was higher than that of CB 89.7% (35/39) (p=0.160, Fisher's exact test). For the diagnosis of malignancy, sensitivities of FNAB and CB were 97.2% (35/36) and 89.7% (26/29), respectively (p=0.316). For the diagnosis of benignancy, sensitivities of FNAB and CB were 100% (16/16) and 90% (9/10), respectively (p=0.384). The specific histologic diagnosis rate of CB was 80% (8/10) in benignancy, which was higher than that of FNAB 56% (9/16) (p=0.398). The pneumothorax rates were 7.7% (4/52) for FNAB and 15.4% (6/39) for CB (p=0.316). Conclusion: Although not statistically significant, a higher overall sensitivity was found in fluoroscopy-guided FNAB in the diagnosis of both malignancy and benignancy, and FNAB also achieved lower complication rates. More specific histologic diagnoses were obtained with CB.