OUTCOMES OF CT FLUOROSCOPY GUIDED FINE-NEEDLE ASPIRATION CYTOLOGY AND CORE NEEDLE BIOPSIES IN SOLITARY LUNG LESIONS

Abstract

Introduction: The frequent and widespread use of imaging in clinical practice, particularly CT, has led to a steep increase in incidental ndings of asymptomatic solitary pulmonary nodules. In this situation, histocytopathological analysis is needed to conrm the diagnosis by CTguided biopsy / FNAC. So, the researcher purposively, designed this study. The aim of this study was to assess the outcomes of CT-Guided Fine-Needle Aspiration Cytology and Core Needle Biopsies of Solitary Lung Lesions. CT-uoroscopy guidance helps in this process by accurate needle positioning thus increase the success rate. Materials and Methods: This was a retrospective study conducted at the Department of Radiology & Imaging in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, during January 2017 to January 2019.Atotal of 270 patients who were referred to the Department of Radiology& Imaging for the evaluation of suspicious solitary lung lesions after the detection of a solitary pulmonary nodule in X-ray or CT scan, were included in this study. The results of CT uoroscopy–guided biopsy and FNAC for the included patients were analyzed to determine the diagnostic accuracy, complication rates, and independent risk factors for diagnostic failure and severe pneumothorax in this study. The factors related to the patients' solitary lesions, and procedures were evaluated by univariate analyses using the twosided Student t test for numeric values and Chi-squared test for categorical values where p<0.05 considered as signicant. Statistical analysis were performed using SPSS, version-23.0.Results: Diagnostic accuracy rate was 95.86%, failure was 4.14%, the overall sensitivity was 92.96%, specicity was 85.23% and the statistically signicant risk factors wereage (p=0.001), sex(p=0.001), smoking stats(p=0.001) emphysema(p=0.001),benign lesions(p=0.001),positioning of the patient for the procedure(p=0.001),location of the lesion(p=0.001) lesion size(p=0.001) pneumothorax (p=0.001) and length from the pleura to the lesion of 1.5 cm or greater,(p=0.001).Pneumothorax requiring drainage occurred in 1.48% of patients. The potential risk factors for pneumothorax requiring drainage were age of 73 years, the presence of emphysema, lesion size ≤ 2.0 cm and length from pleura to lesion of ≥ 1.5 cm. The major complications were being observed pneumothorax 15(5.63%), haemoptysis16 (6.01%), and hemothorax 03(1.12%).Conclusion: CT-Fluoroscopy Guided Fine-Needle Aspiration Cytology and biopsy has a high diagnostic accuracy; complication rates were acceptable and comparable to those of previous studies.