| Purpose:The purpose of this study is to investigate the diagnostic performance and complication rate of percutaneous transthoracic CT-guided co-axial core needle biopsy(PTCNB)in persistent consolidation and evaluate its safety in routine clinical practice.Materials and methods:We have retrospectively enrolled a total of 685 consecutive patients with persistent pulmonary consolidation who underwent PTCNB in China-Japan Friend hospital between January 2016 to December 2020.The basic information of patients,the diagnostic yield and complication rate of PTCNB and the pathological results of the puncture samples have been counted.The cases were divided into≥3cm(505 cases)and<3cm(180 cases)groups according to the lesion size,and the differences between the two groups were compared.According to histopathological and microbiological analysis,the results of biopsy specimens were categorized as follows:malignant,specific benign,non-specific benign and non-diagnostic.The final diagnosis was established by surgical resection or clinicoradiological follow-up for at least 12 months following biopsy.Diagnostic yield of PTCNB was defined as the percentage of the true diagnosis from biopsy as malignant and specific benign lesions.Results:The final diagnosis included 238 malignant lesions,252 specific benign lesions and 195 non-specific benign lesions.Of them,54(54/685;7.88%)cases were obtained by surgery and the remaining 631(631/685;92.17%)cases were by clinicoradiological follow-up for at least 12 months.Diagnostic yield of PTCNB for persistent pulmonary consolidations was 66.28%.The total accuracy,sensitivity,specificity of PTCNB for malignancy diagnosis was 94.45%,84.87%,100%,respectively.Of all cases,359 biopsy procedures(359/685;52.41%)developed complications,including 203(203/685;29.64%)pneumothorax,128(128/685;18.69%)intrapulmonary hemorrhage,57(57/685;8.32%)hemoptysis,and 4(4/685;0.58%)other abnormity(3 pneumoderma,1 transient loss of consciousness).Compared to lesions smaller than 3cm,higher diagnostic yield(70.89%),lower complication incidence(38.22%)and shorter procedure time(8.78min)were observed in lesions≥3cm group.Conclusion:PTCNB in persistent consolidation is a safe and effective procedure,which provide relatively high diagnostic yield and acceptable complication,especially in size over 3cm lesions.Purpose:The purpose of this study is to compare the diagnostic yield and the complication rate between percutaneous transthoracic CT-guided co-axial needle biopsy(PTCNB)and transbronchial lung biopsy(TBLB)of persistent pulmonary consolidation.Materials and methods:From January 1,2016 to December 31,2020,we have retrospectively enrolled a total of 155 consecutive patients with persistent pulmonary consolidation who underwent both TBLB and PTCNB.The basic information of patients,the diagnostic yield and complication rate of PTCNB/TBLB and the pathological results of the biopsy samples have been counted.The diagnostic accuracy,specificity,sensitivity and complication rate of the two biopsy methods for persistent lung consolidation has been compared.According to histopathological and microbiological analysis,the results of biopsy specimens were categorized as follows:malignant,specific benign,non-specific benign and non-diagnostic.The final diagnosis was established by surgical resection or clinicoradiological follow-up for at least 12 months following biopsy.Diagnostic yield of PTCNB/TBLB was defined as the percentage of the true diagnosis from biopsy as malignant and specific benign lesions.Results:According to the standard reference,the final biopsy diagnoses of 11 cases were confirmed true malignant based on the surgical resections,the remaining were confirmed by clinical and imaging follow-up for at least 12 months.The overall diagnostic accuracy,sensitivity and specificity of PTCNB for malignant diagnosis were 91.61%,72.34%and 100%,whereas of TBLB were 87.74%,59.57%and 100%.The diagnostic yield of PTCNB and TBLB were 50.32%and 25.16%respectively.For the TBLB-based negative cases,PTCNB provided a definite diagnostic yield of 37.93%.There were 45(45/155,29.03%),22(22/155,14.19%)and 13(13/155,8.39%)patients who experienced pneumothorax,intrapulmonary hemorrhage and hemoptysis respectively in PTCNB,while there were only 5(5/155,3.22%)cases of mild intraprocedural bleeding occurring in TBLB.Conclusion:PTCNB is an effective and safe modality,associated with higher diagnostic yield and better diagnostic accuracy compared to TBLB for persistent consolidation,especially as the complementary method for TBLB-based negative lung lesions. |
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