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FNA and CNB in the diagnosis of pulmonary lesions: a single-center experience on 665 patients, comparison between two periods

Abstract

Purpose

To evaluate the diagnostic yield and complication rate of 2 different biopsy techniques (fine-needle aspiration, FNA, and core-needle biopsy, CNB) in the diagnosis of pulmonary lesions in 2 distinct periods, 2010-2012 and 2013-2015.

Methods

We retrospectively analyzed the results of 691 CT-guided lung biopsies in 665 patients who were divided into 2 groups: cohort 1 (January 2010 to December 2012) was composed of 271 consecutive patients with 284 procedures either by FNA or CNB; cohort 2 (January 2013 to December 2015) was composed of 394 patients with 407 CNBs. Univariate and multivariate logistic regression modeling was used for selected outcomes including diagnostic yield, bleeding and pneumothorax.

Results

Cohort 1 comprised 165 men and 106 women (mean age 68.5 years) with 180 FNAs and 104 CNBs; cohort 2 comprised 229 men and 165 women (mean age 66.4 years) with 407 CNBs. The diagnostic yield increased in cohort 2 with respect to cohort 1. There was a slight increase in CT procedure complications (pneumothorax and bleeding) from cohort 1 to cohort 2. The overall risk of complications was greater for lesions ≤20 mm and for lesions at >20 mm distance from the pleura.

Conclusions

CT-guided CNB had a higher diagnostic yield than discretional use of either FNA or CNB; there was a slight but acceptable increase in complication rates.

Tumori 2017; 103(4): 360 - 366

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000633

Authors

Alfonso Vittorio Marchianò, Maria Cosentino, Giuseppe Di Tolla, Francesca Gabriella Greco, Mario Silva, Nicola Sverzellati, Alessandra Fabbri, Elena Tamborini, Giuseppe Lo Russo, Luigi Mariani, Luca Lalli, Ugo Pastorino

Article History

Disclosures

Financial support: None.
Conflict of interest: None.

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Authors

Affiliations

  • Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy
  • School of Specialization of Diagnostic and Interventional Radiology, University of Milan, San Donato Milanese (Milan) - Italy
  • Department of Clinical Sciences, Section of Radiology, University of Parma, Parma - Italy
  • Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy
  • Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy
  • Department of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy
  • Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy

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