Diagnostic Accuracy and Safety of CT-Guided Percutaneous Transthoracic Needle Biopsies: 14-Gauge Versus 22-Gauge Needles

• Published in: Journal of vascular and interventional radiology Vol. 27; no. 5; pp. 674 - 681
• Main Authors: Ocak, Sebahat, MD, PhD, Duplaquet, Fabrice, MD, Jamart, Jacques, MD, MSc, Pirard, Lionel, MD, Weynand, Birgit, MD, Delos, Monique, MD, Eucher, Philippe, MD, Rondelet, Benoît, MD, PhD, Dupont, Michael, MD, Delaunois, Luc, MD, PhD, Sibille, Yves, MD, PhD, Dahlqvist, Caroline, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2016
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy, Fine-Needle - adverse effects; Biopsy, Fine-Needle - instrumentation; Biopsy, Large-Core Needle - adverse effects; Biopsy, Large-Core Needle - instrumentation; Biopsy, Large-Core Needle - mortality; Equipment Design; Female; Hemorrhage - etiology; Humans; Image-Guided Biopsy - adverse effects; Image-Guided Biopsy - instrumentation; Image-Guided Biopsy - methods; Image-Guided Biopsy - mortality; Male; Medical Records; Middle Aged; Needles; Pneumothorax - etiology; Predictive Value of Tests; Radiography, Interventional - methods; Radiology; Reproducibility of Results; Retrospective Studies; Risk Factors; Thoracic Diseases - pathology; Tomography, X-Ray Computed; Young Adult; transthoracic needle biopsy; TTNB; FNB; core-needle biopsy; fine-needle biopsy; CNB
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2016.01.134

Abstract Purpose To compare the diagnostic accuracy and safety of a 14-gauge core needle versus a 22-gauge fine needle in the evaluation of thoracic lesions by CT–guided percutaneous transthoracic needle biopsy (TTNB). Materials and Methods Medical charts of all patients who underwent CT-guided percutaneous transthoracic core-needle biopsies (CNBs) with a 14-gauge Spirotome device (99 patients, 102 procedures) and fine-needle biopsies (FNBs) with a 22-gauge Rotex needle (92 patients, 102 procedures) between 2007 and 2013 at a single academic institution were retrospectively reviewed. Variables that could influence diagnostic accuracy and safety were collected. Results The overall and cancer-specific diagnostic accuracy rates were 90% and 94%, respectively, with CNB, versus 82% and 89% with FNB. Precise cancer type/subtype was provided by 97% of CNBs versus 65% of FNBs ( P < .001). In patients with lung cancer considered for targeted therapy, biomarker analyses were feasible in 80% of CNBs versus 0% of FNBs ( P < .001). The rate of pneumothorax was significantly higher with CNB versus FNB (31% vs 19%; P = .004), but chest tube insertion rates were similar (10% vs 11%, respectively). Major bleeding complications occurred in 1% of CNBs versus 2% of FNBs and were associated with one death in the CNB group. Conclusions Percutaneous transthoracic CNB with a 14-gauge Spirotome needle provided better characterization of cancer lesions and allowed biomarker analyses without a significant increase in major procedural complications.