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Nondiagnostic Computed Tomography-guided Percutaneous Lung Biopsies Are More Likely When Infection Is Suspected.

Publication ,  Journal Article
Haas, BM; Elicker, BM; Nguyen, J; Ordovas, KG; Jones, KD; Henry, TS; Naeger, DM
Published in: J Thorac Imaging
May 2016

PURPOSE: The purpose of this study was to assess the incidence of nondiagnostic computed tomography-guided lung biopsy results, stratified by biopsy indication, and determine the final diagnosis in such cases. MATERIALS AND METHODS: Following institutional review board approval, pathology results from CT-guided lung biopsies over a 5-year period at 2 institutions were categorized as diagnostic or nondiagnostic. Each biopsy's indication was categorized as being for a lesion considered likely to be cancer, infection, or uncertain. For all nondiagnostic biopsies, the medical chart was reviewed to determine the final clinical diagnosis. RESULTS: A total of 660 biopsies were evaluated, 139 (21%) of which were nondiagnostic. Of these 139 patients, the final clinical diagnosis was infection in 37%, cancer in 30%, and a benign noninfectious diagnosis in 10%; 23% remained undiagnosed at last available follow-up. Among the patients in whom there was a high pretest suspicion for cancer, 13% were nondiagnostic, 45% of which were cancer and 27% were infection. Among biopsies of lesions with pretest probability for both cancer and infection, 51% were nondiagnostic; on clinical follow-up these were determined to be infection in 34% and cancer in 14%. When there was high pretest suspicion for infection, 73% were nondiagnostic, of which 13% were cancer on clinical follow-up, and 88% were infection. The rate of nondiagnostic biopsies was statistically significantly different (P<0.001) among the 3 groups. CONCLUSIONS: Nondiagnostic biopsies are common and occur most frequently when there is a moderate or high pretest suspicion for infection. Among all nondiagnostic biopsies, regardless of indication, cancer and infection were diagnosed on follow-up in similar proportions.

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Published In

J Thorac Imaging

DOI

EISSN

1536-0237

Publication Date

May 2016

Volume

31

Issue

3

Start / End Page

151 / 155

Location

United States

Related Subject Headings

  • Young Adult
  • Tomography, X-Ray Computed
  • Sensitivity and Specificity
  • Retrospective Studies
  • Respiratory Tract Infections
  • Radiography, Interventional
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Lung
 

Citation

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Haas, B. M., Elicker, B. M., Nguyen, J., Ordovas, K. G., Jones, K. D., Henry, T. S., & Naeger, D. M. (2016). Nondiagnostic Computed Tomography-guided Percutaneous Lung Biopsies Are More Likely When Infection Is Suspected. J Thorac Imaging, 31(3), 151–155. https://doi.org/10.1097/RTI.0000000000000207
Haas, Brian M., Brett M. Elicker, Janet Nguyen, Karen G. Ordovas, Kirk D. Jones, Travis S. Henry, and David M. Naeger. “Nondiagnostic Computed Tomography-guided Percutaneous Lung Biopsies Are More Likely When Infection Is Suspected.J Thorac Imaging 31, no. 3 (May 2016): 151–55. https://doi.org/10.1097/RTI.0000000000000207.
Haas BM, Elicker BM, Nguyen J, Ordovas KG, Jones KD, Henry TS, et al. Nondiagnostic Computed Tomography-guided Percutaneous Lung Biopsies Are More Likely When Infection Is Suspected. J Thorac Imaging. 2016 May;31(3):151–5.
Haas, Brian M., et al. “Nondiagnostic Computed Tomography-guided Percutaneous Lung Biopsies Are More Likely When Infection Is Suspected.J Thorac Imaging, vol. 31, no. 3, May 2016, pp. 151–55. Pubmed, doi:10.1097/RTI.0000000000000207.
Haas BM, Elicker BM, Nguyen J, Ordovas KG, Jones KD, Henry TS, Naeger DM. Nondiagnostic Computed Tomography-guided Percutaneous Lung Biopsies Are More Likely When Infection Is Suspected. J Thorac Imaging. 2016 May;31(3):151–155.

Published In

J Thorac Imaging

DOI

EISSN

1536-0237

Publication Date

May 2016

Volume

31

Issue

3

Start / End Page

151 / 155

Location

United States

Related Subject Headings

  • Young Adult
  • Tomography, X-Ray Computed
  • Sensitivity and Specificity
  • Retrospective Studies
  • Respiratory Tract Infections
  • Radiography, Interventional
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Lung