Dominguez-Konicki Lillian, Karam Adib R, Furman Michael S, Grand David J
The Warren Alpert Medical School of Brown University, 22 Richmond St., Providence, RI 02903, United States of America.
Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy St., Providence, RI 02903, United States of America.
Clin Imaging. 2020 Oct;66:7-9. doi: 10.1016/j.clinimag.2020.04.040. Epub 2020 May 3.
The aim of our study is to evaluate the diagnostic performance of CT-guided biopsy of lung nodules ≤10 mm based on their lobar and segmental location.
This was a retrospective study performed on 193 CT-guided percutaneous transthoracic needle biopsies of lung nodules ≤10 mm in greatest dimension, between January 1, 2013 and April 30, 2019. Biopsies were classified as either diagnostic or non-diagnostic based on final cytology and surgical pathology reports. Diagnostic results were those that met parameters for malignancy or a specific benign diagnosis, whereas atypical cells, non-specific benignity, or insufficient specimen were considered non-diagnostic.
A total of 1577 CT-guided percutaneous transthoracic needle biopsies were reviewed. Of these, 193 nodules (12.24%) measured ≤10 mm and were selected for further analysis. Of the 193 biopsies, 138 yielded diagnostic results while 56 yielded nondiagnostic results (71% vs 29%, respectively). When analyzed by nodule location, the superior segments of the lower lobes boasted the highest diagnostic yield compared to nodules located in the basal segments of the lower lobes which had the lowest diagnostic yield (84.2% vs 64.7%, respectively). Nodules in the upper lobes and in the middle lobes had a diagnostic yield of 70% and 66.7%, respectively.
The diagnostic performance of CT-guided biopsy of lung nodules ≤10 mm in diameter may be affected by lobar and segmental location. While the overall performance was good (diagnostic yield of 71%), the yield varied nearly 20% depending on location.
我们研究的目的是基于肺结节≤10mm的叶和段位置评估CT引导下肺结节活检的诊断性能。
这是一项回顾性研究，对2013年1月1日至2019年4月30日期间193例最大直径≤10mm的肺结节进行CT引导下经皮经胸针吸活检。根据最终细胞学和手术病理报告，活检分为诊断性或非诊断性。诊断结果是那些符合恶性或特定良性诊断参数的结果，而异型细胞、非特异性良性或标本不足则被视为非诊断性。
共回顾了1577例CT引导下经皮经胸针吸活检。其中，193个结节（12.24%）测量≤10mm并被选作进一步分析。在193例活检中，138例获得诊断结果，56例获得非诊断结果（分别为71%和29%）。按结节位置分析时，下叶上段的诊断率最高，而下叶基底段的结节诊断率最低（分别为84.2%和64.7%）。上叶和中叶的结节诊断率分别为70%和66.7%。
直径≤10mm的肺结节CT引导下活检的诊断性能可能受叶和段位置的影响。虽然总体性能良好（诊断率为71%），但根据位置不同，诊断率相差近20%。
