Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan.
Acad Radiol. 2010 Jun;17(6):772-8. doi: 10.1016/j.acra.2010.02.012.
The aims of this study were to compare diagnostic accuracy between computed tomography (CT)-guided percutaneous cutting needle biopsy (PCNB) and surgery or open biopsy for thymic epithelial tumors in accordance with the World Health Organization (WHO) classification and to evaluate computed tomographic diagnosis additionally.
Subjects were 20 patients (11 men, 9 women) in whom CT, CT-guided PCNB, and surgery had been performed for anterior mediastinal tumors. All diagnoses of both CT-guided PCNB and surgery or open biopsy were made in accordance with the WHO classification. Computed tomographic diagnoses were performed by two radiologists on the basis of radiologic characteristics previously reported according to the simplified WHO classification (types A and AB, type B1, types B2 and B3, and thymic carcinoma). The concordance of the WHO classification or the simplified WHO classification between the diagnosis on either CT or CT-guided PCNB and that on surgery was evaluated using the weighted kappa statistic.
The histologic classifications on the basis of surgical resection specimens were as follows: type A, n = 3; type AB, n = 5; type B1, n = 3; type B2, n = 4; type B3, n = 4; and thymic carcinoma, n = 1. The overall concordance with the diagnosis according to the WHO classification established using CT-guided PCNB specimens (weighted kappa = 0.757) was higher than that using computed tomographic diagnosis (weighted kappa = 0.437).
CT-guided PCNB is a technique with good concordance of the WHO classification of thymic epithelial tumors between the diagnoses of surgery or open biopsy.
本研究旨在比较 CT 引导下经皮切割针活检（PCNB）与手术或开放活检在符合世界卫生组织（WHO）分类的情况下对胸内上皮性肿瘤的诊断准确性，并额外评估 CT 诊断。
本研究共纳入 20 例（男 11 例，女 9 例）因前纵隔肿瘤接受 CT、CT 引导下 PCNB 和手术的患者。所有 CT 引导下 PCNB 和手术或开放活检的诊断均符合 WHO 分类。CT 诊断由两位放射科医生根据先前报道的简化 WHO 分类（A 型和 AB 型、B1 型、B2 型和 B3 型以及胸腺癌）的影像学特征进行。根据简化 WHO 分类或 CT 或 CT 引导下 PCNB 上的诊断与手术上的诊断之间的 WHO 分类的一致性，使用加权 Kappa 统计进行评估。
根据手术切除标本的组织学分类如下：A型 3 例，AB 型 5 例，B1 型 3 例，B2 型 4 例，B3 型 4 例，胸腺癌 1 例。使用 CT 引导下 PCNB 标本诊断符合 WHO 分类的总体一致性（加权 Kappa = 0.757）高于使用 CT 诊断的一致性（加权 Kappa = 0.437）。
CT 引导下 PCNB 是一种技术，与手术或开放活检的胸内上皮性肿瘤 WHO 分类具有良好的一致性。
