Keywords:
Interventional Radiology, Interventional non-vascular, CT, Biopsy, Cancer, Retrospective, Observational, Performed at one institution
Authors:
E. RONCONI1, M. A. Tipaldi2, T. Polidori1, F. Laurino3, A. Pisano1, A. Zolovkins2, G. Orgera2, A. Laghi2, M. Rossi2; 1roma/IT, 2Rome/IT, 3EBOLI/IT
DOI:
10.26044/ecr2020/C-15370
Results
Technical success was considered when the tissue sample was deemed appropriate to asses a specific malignant or benign pathology. The overall technical success was 78% (n =250), 68% (n=218) malignant and 10% (n=32) benign. Technical failure occurred in 22% (71 pz) because of inadequate samples (blood cloth, necrosis, normal parenchima or insufficient material for diagnosis).
The mean session duration was 19 minutes and the average duration of needle position and sampling was 10 minutes. The average DLP for the CT fluoroscopy alone was 65,9mGy x Cm2.
Overall complication rate was 35% and major complications rate was 6%, all pneumothorax requiring the placement of a drainage tube.
A wide panel of variables were tested in the univariate setting in order to determine which were the ones most associated with unsuccessful procedures: as an example sex, operator, nodule shape and density failed to show a significant correlation with success, and were thus not taken into account when constructing the score. We believe that some of those features, such as the aspect of the nodule, are likely to be associated with failure, but did not reach the desired significancy level out of low presence in the study population (as an example pure GG’s nodules, in which CTLB is known for a low diagnostic yeld, were just 19 out of 321). The model performances indicates a good discrimination capability (the C – index for the model is 0.71; 95% CI 0.64-0.77) and goodness-of-fit, with an Hosmer-Lemeshow test of p=0.173. Three cluster of low (<50%), medium (50 – 60 %) and high (>60%) risk of technical unsuccess were thus highlighted according to nodule and patient characteristics. When looking at the model we can see how a low 18-FDG uptake in the target lesion resulted as the factor which correlated the most with technical failure: all patients falling into the >50% risk of unsuccess group had this feature. A SUV max value of 2,5 was the threshold to discriminate nodule uptake at 18-FDG PET examination: 251 (79%) lesions resulted “positive” and 70 (21%) “negative”. The other key factors determining success were a maximum diameter of less than 18 mm and a basal localization of the lesion.