Diagnostic Outcomes of CT-guided Percutaneous Transthoracic Needle Biopsy of Pulmonary Consolidation

Abstract

Pulmonary consolidation is a frequently encountered clinical entity and sometimes needs tissue sampling for definitive diagnosis. We evaluated the diagnostic accuracy and complications of computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) of pulmonary consolidation. Moreover, we analyzed factors which may predict malignant outcome. All CT-guided PTNB of pulmonary consolidation performed from January 2013 to December 2018 were retrospectively reviewed. Patient demographics, lesion characteristics, procedural techniques, complications, and pathological reports were assessed. The diagnostic accuracy and complications of the procedure were evaluated. Clinical features and imaging characteristics were analyzed as predictors of malignant outcome. Statistical analysis was performed using multivariate analysis. Sixty-three patients (male: 39, female: 24, median age: 65 years, range: 20 to 91 years) were enrolled. The final diagnosis was malignancy in 33 (52.4%) patients and benign in 30 (47.6%) patients. CT-guided PTNB provided a diagnostic yield of 88.9%. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of CT-guided PTNB for the diagnosis of malignancy were 96.9%, 100%, 100%, 96.7%, and 98.4%, respectively. The rates of pneumothorax and pulmonary hemorrhage were 33.3% and 38.1%, respectively. All patients had clinical improvement after conservative treatment. No procedure-related mortality was detected. Advanced age (p = 0.004) and lower lobe localization (p = 0.026) were found to be risk factors for malignant outcome. CT-guided PTNB provides a high diagnostic yield and is a safe technique for characterization of pulmonary consolidation. The risk factors for malignant outcome are advanced age and location in the lower lobe.