Diagnostic Value of Percutaneous Lung Biopsy under CT Guidance for Ground-glass Opacity Pulmonary Lesions_Chinese Journal of Evidence-Based Medicine

Authors：

 YANGao-wu ¹ , YANGao-wen ² , SUNQing-quan ¹ , ZHOUYu ³ , LILi-fa ⁴ , ZENGHao ⁵ , ZHANGChuan ¹ ,  LIBing ¹ , XUXiao-xue ¹ ,  YANGHan-feng ¹ , DUYong ¹

1. Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China;
2. Department of Radiology, the First People's Hospital of Suining, Suining 629000, China;
3. Department of Cardio-Thoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China;
4. Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China;
5. Department of Radiology, Suining Central Hospital, Suining 629000, China;

Corresponding?author：

LIBing, Email: cbylb@qq.com; YANGHan-feng, Email: 505254007@qq.com

Keywords：

Lung; Biopsy; Ground-glass opacity; Tomography; X-ray computed

DOI：

10.7507/1672-2531.20160059

Video：

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Objective To explore the diagnostic value of CT-guided percutaneous needle aspiration biopsy (PTNB) for ground-glass opacity (GGO) pulmonary lesions. Methods A retrospective design was used to collect clinical data of patients with GGO lesions admitted in the Affiliated Hospital of North Sichuan Medical College between Jan. 2009 to Jan 2015. Patients were divided into groups according the lesion size (≤10 mm, 10-20 mm,≥20 mm), length of needle path (≤5 cm, 5-9 cm,≥9 cm) and percentage of GGO component (50%-90%, >90%), respectively. The total and subgroups of sensitivity, specificity, and diagnostic accuracy of CT guided PTNB for diagnosing GGO were calculated and the differences among subgroups were compared using Fisher's exact test. Statistical analysis was conducted by using SPSS 17.0 software. Results A total of 60 patients involving 48 malignant and 12 benign lesions were included. The total sensitivity, specificity, and accuracy of CT guided PTNB for diagnosing GGO were 87.5%, 100% and 90%, respectively. There were no significant differences among the subgroups based on the lesion size, length of needle path, and percentage of GGO component (all P values >0.05). Conclusion CT-guided PTNB can be used as one of the diagnostic modalities for lung GGO lesions with a moderate diagnostic value.

Citation： YANGao-wu, YANGao-wen, SUNQing-quan, ZHOUYu, LILi-fa, ZENGHao, ZHANGChuan, LIBing, XUXiao-xue, YANGHan-feng, DUYong. Diagnostic Value of Percutaneous Lung Biopsy under CT Guidance for Ground-glass Opacity Pulmonary Lesions. Chinese Journal of Evidence-Based Medicine, 2016, 16(4): 378-382. doi: 10.7507/1672-2531.20160059 Copy

1.	Hansell DM, Bankier AA, MacMahon H, et al. Fleischner Society:glossary of terms for thoracic imaging. Radiology, 2008, 246(3):697-722.
2.	Henschke CI, McCauley DI, Yankelevitz DF, et al. Early Lung Cancer Action Project:overall design and findings from baseline screening. Lancet, 1999, 354(9173):99-105.
3.	Collins J, SternE J. Ground-glass opacity at CT:the ABCs. AJR Am J Roentgenol, 1997, 169(2):355-367.
4.	許澤兵, 翟昭華, 何菲, 等. CT引導下經皮肺穿刺活檢并發癥的相關因素Logistic分析. 川北醫學院學報, 2012, 26(2):167-171.
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6.	Kim TJ, Lee JH, Lee CT, et al. Diagnostic accuracy of CT guided core biopsy of ground-glass opacity pulmonary lesions. AJR Am J Roentgenol, 2008, 190(1):234-239.
7.	Lu CH, Hsiao CH, Chang YC, et al. Percutaneous computed tomography-guided coaxial core biopsy for small pulmonary lesions with ground-glass attenuation. J Thorac Oncol, 2012, 7(1):143-150.
8.	嚴高武, 孫清泉, 嚴高文, 等. CT引導下經皮肺穿刺活檢診斷肺部磨玻璃樣病變. 中國介入影像與治療學雜志, 2016, 13(2):77-81.
9.	岳鵬程, 朱蕓. 纖維支氣管鏡在支氣管肺癌診斷中的應用(附112例報告). 川北醫學院學報, 2009, 24(3):260-262.
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11.	孫勇, 楊敏, 高劍波, 等. CT引導下活檢聯合靶向治療對肺部炎性病變的臨床價值. 臨床放射學雜志, 2016, 35(1):135-137.
12.	王亞琴, 劉鈞. 肺針吸細胞病理學在肺部疾病診斷中的應用. 川北醫學院學報, 2014, 29(3):222-224.
13.	Hur J, Lee HJ, Nam JE, et al. Diagnostic accuracy of CT fluoroscopy-guided needle aspiration biopsy of ground-glass opacity pulmonary lesions. AJR Am J Roentgenol, 2009, 192(3):629-634.
14.	王海彥, 莊一平, 張晉, 等. CT 引導下細針穿刺活檢對肺部空洞性病變的診斷價值. 臨床放射學雜志, 2013, 32(7):1021-1025.
15.	林杰,楊漢豐.黃小華等. CT引導下經皮肺穿刺活檢并發癥的分析. 川北醫學院學報, 2007, 22(6):573-575.
16.	Yamagami T, Yoshimatsu R, Miura H, et al. Diagnostic performance of percutaneous lung biopsy using automated biopsy needles under CT-fluoroscopic guidance for ground glass opacity lesions. Br J Radiol, 2013, 86(1022):20120447.
17.	Inoue D, Gobara H, Hiraki T, et al. CT fluoroscopy guided cutting needle biopsy of focal pure ground-glass opacity lung lesions:diagnostic yield in 83 lesions. Eur J Radiol, 2012, 81(2):354-359.
18.	Yamauchi Y, Izumi Y, Nakatsuka S, et al. Diagnostic performance of percutaneous core needle lung biopsy under multi-CT fluoroscopic guidance for ground-glass opacity pulmonary lesions. Eur J Radiol, 2011, 79(2):e85-e89.
19.	陳萬海, 沈曉文, 孫新剛, 等. 經皮肺活檢常見并發癥風險因素分析. 介入放射學雜志, 2012, 21(2):168-171.
20.	嚴高武, 嚴高文, 胡海, 等. C臂CT引導下經皮肺穿刺活檢對肺部結節診斷價值的Meta分析. 中國循證醫學雜志, 2015, 15(12):1387-1392.
21.	唐孝華, 何國德, 周文香, 等. CT導向下細針引導技術及同軸技術在肺腫塊穿刺活檢中的臨床應用. 川北醫學院學報, 2009, 24(1):47-50.
22.	Niu XK, Bhetuwal A, Yang HF. CT-guided core needle biopsy of pleural lesions:evaluating diagnostic yield and associated complications. Korean J Radiol, 2015, 16(1):206-212.
23.	Li Y, Du Y, Yang HF, et al. CT-guided percutaneous core needle biopsy for small (≤ 20 mm) pulmonary lesions. Clin Radiol, 2013, 68(1):e43-e48.
24.	鄭玉勁, 吳慶德, 蒙立艷. "呼吸針控"在CT引導下經皮肺穿刺近膈小病灶中的應用. 中國介入影像與治療學雜志, 2016, 13(2):65-67.

1. Hansell DM, Bankier AA, MacMahon H, et al. Fleischner Society:glossary of terms for thoracic imaging. Radiology, 2008, 246(3):697-722.
2. Henschke CI, McCauley DI, Yankelevitz DF, et al. Early Lung Cancer Action Project:overall design and findings from baseline screening. Lancet, 1999, 354(9173):99-105.
3. Collins J, SternE J. Ground-glass opacity at CT:the ABCs. AJR Am J Roentgenol, 1997, 169(2):355-367.
4. 許澤兵, 翟昭華, 何菲, 等. CT引導下經皮肺穿刺活檢并發癥的相關因素Logistic分析. 川北醫學院學報, 2012, 26(2):167-171.
5. 趙罡, 史曉寶, 盧再嗚, 等. CT引導下肺內直徑小于等于30 mm以下結節穿刺活檢:探討穿刺活檢準確率的影響因素及其安全性.中國臨床醫學影像雜志, 2015, 26(6):391-394.
6. Kim TJ, Lee JH, Lee CT, et al. Diagnostic accuracy of CT guided core biopsy of ground-glass opacity pulmonary lesions. AJR Am J Roentgenol, 2008, 190(1):234-239.
7. Lu CH, Hsiao CH, Chang YC, et al. Percutaneous computed tomography-guided coaxial core biopsy for small pulmonary lesions with ground-glass attenuation. J Thorac Oncol, 2012, 7(1):143-150.
8. 嚴高武, 孫清泉, 嚴高文, 等. CT引導下經皮肺穿刺活檢診斷肺部磨玻璃樣病變. 中國介入影像與治療學雜志, 2016, 13(2):77-81.
9. 岳鵬程, 朱蕓. 纖維支氣管鏡在支氣管肺癌診斷中的應用(附112例報告). 川北醫學院學報, 2009, 24(3):260-262.
10. 王昌國, 曾大雄, 雷偉, 等. CT引導下經皮肺穿刺與超聲引導下經支氣管鏡肺活檢對肺周圍型病變的診斷價值.中華結核與呼吸雜志, 2015, 38(12):897-900.
11. 孫勇, 楊敏, 高劍波, 等. CT引導下活檢聯合靶向治療對肺部炎性病變的臨床價值. 臨床放射學雜志, 2016, 35(1):135-137.
12. 王亞琴, 劉鈞. 肺針吸細胞病理學在肺部疾病診斷中的應用. 川北醫學院學報, 2014, 29(3):222-224.
13. Hur J, Lee HJ, Nam JE, et al. Diagnostic accuracy of CT fluoroscopy-guided needle aspiration biopsy of ground-glass opacity pulmonary lesions. AJR Am J Roentgenol, 2009, 192(3):629-634.
14. 王海彥, 莊一平, 張晉, 等. CT 引導下細針穿刺活檢對肺部空洞性病變的診斷價值. 臨床放射學雜志, 2013, 32(7):1021-1025.
15. 林杰,楊漢豐.黃小華等. CT引導下經皮肺穿刺活檢并發癥的分析. 川北醫學院學報, 2007, 22(6):573-575.
16. Yamagami T, Yoshimatsu R, Miura H, et al. Diagnostic performance of percutaneous lung biopsy using automated biopsy needles under CT-fluoroscopic guidance for ground glass opacity lesions. Br J Radiol, 2013, 86(1022):20120447.
17. Inoue D, Gobara H, Hiraki T, et al. CT fluoroscopy guided cutting needle biopsy of focal pure ground-glass opacity lung lesions:diagnostic yield in 83 lesions. Eur J Radiol, 2012, 81(2):354-359.
18. Yamauchi Y, Izumi Y, Nakatsuka S, et al. Diagnostic performance of percutaneous core needle lung biopsy under multi-CT fluoroscopic guidance for ground-glass opacity pulmonary lesions. Eur J Radiol, 2011, 79(2):e85-e89.
19. 陳萬海, 沈曉文, 孫新剛, 等. 經皮肺活檢常見并發癥風險因素分析. 介入放射學雜志, 2012, 21(2):168-171.
20. 嚴高武, 嚴高文, 胡海, 等. C臂CT引導下經皮肺穿刺活檢對肺部結節診斷價值的Meta分析. 中國循證醫學雜志, 2015, 15(12):1387-1392.
21. 唐孝華, 何國德, 周文香, 等. CT導向下細針引導技術及同軸技術在肺腫塊穿刺活檢中的臨床應用. 川北醫學院學報, 2009, 24(1):47-50.
22. Niu XK, Bhetuwal A, Yang HF. CT-guided core needle biopsy of pleural lesions:evaluating diagnostic yield and associated complications. Korean J Radiol, 2015, 16(1):206-212.
23. Li Y, Du Y, Yang HF, et al. CT-guided percutaneous core needle biopsy for small (≤ 20 mm) pulmonary lesions. Clin Radiol, 2013, 68(1):e43-e48.
24. 鄭玉勁, 吳慶德, 蒙立艷. "呼吸針控"在CT引導下經皮肺穿刺近膈小病灶中的應用. 中國介入影像與治療學雜志, 2016, 13(2):65-67.

Chinese Journal of Evidence-Based Medicine

Diagnostic Value of Percutaneous Lung Biopsy under CT Guidance for Ground-glass Opacity Pulmonary Lesions

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