Results
Technical success rate was achieved in 100% of cases.
Accuracy was 94.2%.
Forty-six lesions were diagnosed as malignant,
20 were benign,
and 4 were indeterminate.
Only 20 of 70 nodules underwent surgical resection and the remaining 50 were followed – up with clinical and CT features.
Of the 20 patients who underwent surgery,
final pathological diagnosis was concordant with FNAB diagnosis in 17 cases and discordant with FNAB diagnoses in 3 cases.
This discrepancy was likely caused by sampling error during fine needle aspiration of lesion.
Of the 50 of 70 nodules who were followed,
26 were malignant,
20 were benign and 4 were indeterminate.
All malignancies diagnosed by FNAB were confirmed by history and imaging.
However of the 20 benign diagnosed by percutaneous biopsy,
foure were false negatives.
In these four cases two patients were diagnosed by FNAB as fibrous tissue and two as non-specific flogoses,
however final pathological diagnosis revealed malignancy in all of them.
These lesions were heterogeneous with areas of necrosis,
wich were likely the areas sampled during FNAB explaning the results.
The overall accuracy,
sensitivity,
specificity,
positive predictive value and negative predictive value were 94.2%,
92%,
100%,
100% and 92%,
respectively.
The accuracy sensitivity,
specificity,
positive predictive value and negative predictive value for lesions 3 cm or smaller were 91.2%,
86.9%,
100%,
100% and 78.5%.
The accuracy sensitivity,
specificity,
positive predictive value and negative predictive value for
lesions larger than 3 cm were 97.2%,
96.2%,
100% 100% and 90%.
The overall complication rate in our study was 22.8% (16/70); eight pneumothoraces in each group and only one required chest tube in the small lesion group.
There were no severe complications such as air embolism or procedure-related death.
There was no difference between the two groups (lesions < or equal to 3cm and lesions > 3cm) in terms of
complications and radiation dose.
In the 34 patients comprising the first group undergoing XperCT guided lung biopsy the average effective dose was 11.14 mSV (range 1.39-27.29 mSv),
while in the 36 patients comprising the second group the average effective dose was 12.10 mSv (range 2.89-49.46 mSv).