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Diagnostic Yield of CT-Guided Percutaneous Transthoracic Needle Biopsy for Diagnosis of Anterior Mediastinal Masses
- Source :
- American Journal of Roentgenology. 205:774-779
- Publication Year :
- 2015
- Publisher :
- American Roentgen Ray Society, 2015.
-
Abstract
- The purpose of this study was to evaluate the diagnostic yield and accuracy of CT-guided percutaneous biopsy of anterior mediastinal masses and assess prebiopsy characteristics that may help to select patients with the highest diagnostic yield.Retrospective review of all CT-guided percutaneous biopsies of the anterior mediastinum conducted at our institution from January 2003 through December 2012 was performed to collect data regarding patient demographics, imaging characteristics of biopsied masses, presence of complications, and subsequent surgical intervention or medical treatment (or both). Cytology, core biopsy pathology, and surgical pathology results were recorded. A per-patient analysis was performed using two-tailed t test, Fisher's exact test, and Pearson chi-square test.The study cohort included 52 patients (32 men, 20 women; mean age, 49 years) with mean diameter of mediastinal mass of 6.9 cm. Diagnostic yield of CT-guided percutaneous biopsy was 77% (40/52), highest for thymic neoplasms (100% [11/11]). Non-diagnostic results were seen in 12 of 52 patients (23%), primarily in patients with lymphoma (75% [9/12]). Fine-needle aspiration yielded the correct diagnosis in 31 of 52 patients (60%), and core biopsy had a diagnostic rate of 77% (36/47). None of the core biopsies were discordant with surgical pathology. There was no statistically significant difference between the diagnostic and the nondiagnostic groups in patient age, lesion size, and presence of necrosis. The complication rate was 3.8% (2/52), all small self-resolving pneumothoraces.CT-guided percutaneous biopsy is a safe diagnostic procedure with high diagnostic yield (77%) for anterior mediastinal lesions, highest for thymic neoplasms (100%), and can potentially obviate more invasive procedures.
- Subjects :
- Adult
Image-Guided Biopsy
Male
medicine.medical_specialty
Lung Neoplasms
Percutaneous
Adolescent
Lymphoma
Mediastinal Neoplasms
Surgical pathology
Young Adult
Predictive Value of Tests
Cytology
medicine
Humans
Radiology, Nuclear Medicine and imaging
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Retrospective cohort study
Thymus Neoplasms
General Medicine
Middle Aged
Neoplasms, Germ Cell and Embryonal
Mediastinal Neoplasm
Exact test
Predictive value of tests
Female
Radiology
Tomography, X-Ray Computed
business
Subjects
Details
- ISSN :
- 15463141 and 0361803X
- Volume :
- 205
- Database :
- OpenAIRE
- Journal :
- American Journal of Roentgenology
- Accession number :
- edsair.doi.dedup.....05578faf663a93490769c975d3743aa0
- Full Text :
- https://doi.org/10.2214/ajr.15.14442