Percutaneous image-guided cutting-needle biopsy of the pleura in the presence of a suspected malignant effusion

• Published in: Radiology Vol. 219; no. 2; p. 510
• Main Authors: Adams, R F, Gleeson, F V
• Format: Journal Article
• Language: English
• Published: United States 01.05.2001
• Subjects: Adult; Aged; Aged, 80 and over; Biopsy, Needle - adverse effects; Female; Humans; Male; Middle Aged; Pleura - pathology; Pleural Effusion, Malignant - diagnosis; Pleural Effusion, Malignant - diagnostic imaging; Predictive Value of Tests; Radiography, Interventional; Sensitivity and Specificity; Tomography, X-Ray Computed; Ultrasonography, Interventional
• ISSN: 0033-8419
• DOI: 10.1148/radiology.219.2.r01ma07510

To evaluate the diagnostic accuracy of percutaneous image-guided cutting-needle biopsy of pleural thickening in the presence of a suspected malignant pleural effusion. Thirty-three adult patients with diffuse or focal pleural thickening (median, 1.0 cm; range, 0.2-6.0 cm), pleural effusion, and suspected pleural malignancy underwent percutaneous image-guided cutting-needle biopsy. Biopsy guidance was performed with computed tomography in 24 patients and ultrasonography in nine patients. A final diagnosis of benign or malignant disease was established with radiologic and clinical follow-up findings and with other histologic or cytologic findings, when available. A correct histologic diagnosis of malignant disease was made in 21 of 24 patients (sensitivity, 88%; specificity, 100%), including 13 of 14 patients with mesothelioma (sensitivity, 93%). A correct histologic diagnosis of benign pleural disease was made in nine patients. Positive and negative predictive values for malignant disease were 100% and 75%, respectively. The overall accuracy was 91%. Complications comprised a chest wall hematoma in one patient. Image-guided percutaneous cutting-needle biopsy of pleural thickening in the presence of a pleural effusion is a safe procedure, with an overall accuracy of 91% in the diagnosis of malignancy.