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.
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4.	许泽兵, 翟昭华, 何菲, 等. CT引导下经皮肺穿刺活检并发症的相关因素Logistic分析. 川北医学院学报, 2012, 26(2):167-171.
5.	赵罡, 史晓宝, 卢再呜, 等. CT引导下肺内直径小于等于30 mm以下结节穿刺活检:探讨穿刺活检准确率的影响因素及其安全性.中国临床医学影像杂志, 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.	严高武, 孙清泉, 严高文, 等. CT引导下经皮肺穿刺活检诊断肺部磨玻璃样病变. 中国介入影像与治疗学杂志, 2016, 13(2):77-81.
9.	岳鹏程, 朱芸. 纤维支气管镜在支气管肺癌诊断中的应用(附112例报告). 川北医学院学报, 2009, 24(3):260-262.
10.	王昌国, 曾大雄, 雷伟, 等. CT引导下经皮肺穿刺与超声引导下经支气管镜肺活检对肺周围型病变的诊断价值.中华结核与呼吸杂志, 2015, 38(12):897-900.
11.	孙勇, 杨敏, 高剑波, 等. CT引导下活检联合靶向治疗对肺部炎性病变的临床价值. 临床放射学杂志, 2016, 35(1):135-137.
12.	王亚琴, 刘钧. 肺针吸细胞病理学在肺部疾病诊断中的应用. 川北医学院学报, 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.	王海彦, 庄一平, 张晋, 等. CT 引导下细针穿刺活检对肺部空洞性病变的诊断价值. 临床放射学杂志, 2013, 32(7):1021-1025.
15.	林杰,杨汉丰.黄小华等. CT引导下经皮肺穿刺活检并发症的分析. 川北医学院学报, 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.	陈万海, 沈晓文, 孙新刚, 等. 经皮肺活检常见并发症风险因素分析. 介入放射学杂志, 2012, 21(2):168-171.
20.	严高武, 严高文, 胡海, 等. C臂CT引导下经皮肺穿刺活检对肺部结节诊断价值的Meta分析. 中国循证医学杂志, 2015, 15(12):1387-1392.
21.	唐孝华, 何国德, 周文香, 等. CT导向下细针引导技术及同轴技术在肺肿块穿刺活检中的临床应用. 川北医学院学报, 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.	郑玉劲, 吴庆德, 蒙立艳. "呼吸针控"在CT引导下经皮肺穿刺近膈小病灶中的应用. 中国介入影像与治疗学杂志, 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. 许泽兵, 翟昭华, 何菲, 等. CT引导下经皮肺穿刺活检并发症的相关因素Logistic分析. 川北医学院学报, 2012, 26(2):167-171.
5. 赵罡, 史晓宝, 卢再呜, 等. CT引导下肺内直径小于等于30 mm以下结节穿刺活检:探讨穿刺活检准确率的影响因素及其安全性.中国临床医学影像杂志, 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. 严高武, 孙清泉, 严高文, 等. CT引导下经皮肺穿刺活检诊断肺部磨玻璃样病变. 中国介入影像与治疗学杂志, 2016, 13(2):77-81.
9. 岳鹏程, 朱芸. 纤维支气管镜在支气管肺癌诊断中的应用(附112例报告). 川北医学院学报, 2009, 24(3):260-262.
10. 王昌国, 曾大雄, 雷伟, 等. CT引导下经皮肺穿刺与超声引导下经支气管镜肺活检对肺周围型病变的诊断价值.中华结核与呼吸杂志, 2015, 38(12):897-900.
11. 孙勇, 杨敏, 高剑波, 等. CT引导下活检联合靶向治疗对肺部炎性病变的临床价值. 临床放射学杂志, 2016, 35(1):135-137.
12. 王亚琴, 刘钧. 肺针吸细胞病理学在肺部疾病诊断中的应用. 川北医学院学报, 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. 王海彦, 庄一平, 张晋, 等. CT 引导下细针穿刺活检对肺部空洞性病变的诊断价值. 临床放射学杂志, 2013, 32(7):1021-1025.
15. 林杰,杨汉丰.黄小华等. CT引导下经皮肺穿刺活检并发症的分析. 川北医学院学报, 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. 陈万海, 沈晓文, 孙新刚, 等. 经皮肺活检常见并发症风险因素分析. 介入放射学杂志, 2012, 21(2):168-171.
20. 严高武, 严高文, 胡海, 等. C臂CT引导下经皮肺穿刺活检对肺部结节诊断价值的Meta分析. 中国循证医学杂志, 2015, 15(12):1387-1392.
21. 唐孝华, 何国德, 周文香, 等. CT导向下细针引导技术及同轴技术在肺肿块穿刺活检中的临床应用. 川北医学院学报, 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. 郑玉劲, 吴庆德, 蒙立艳. "呼吸针控"在CT引导下经皮肺穿刺近膈小病灶中的应用. 中国介入影像与治疗学杂志, 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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