ObjectiveTo systematically review the diagnostic accuracy of C-arm cone-beam CT (CBCT)-guided percutaneous transthoracic needle biopsy (PTNB) for lung nodules. MethodsWe electronically searched databases including PubMed, EMbase, EBSCO, Ovid, CBM, VIP, WanFang Data and CNKI from inception to Feb 28th, 2015, to collect diagnostic studies of CBCT-guided PTNB for lung nodules. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies by QUADAS-1 tool. Then, meta-analysis was performed by Stata 12.0 and Meta-DiSc 1.4 softwares for calculating pooled sensitivity (Sen), specificity (Spe), positive likelihood ration (+LR), negative likelihood ration (-LR), and diagnostic odds ratio (DOR), drawing summary receiver operating characteristic (SROC) curve and estimating area under the curve (AUC). ResultsA total of 9 studies involving 1 815 patients were included. The results of meta-analysis showed that the pooled Sen, Spe, +LR,-LR, and DOR were 0.95 (95%CI 0.92 to 0.96), 1.00 (95%CI 0.66 to 1.00), 2 076.58 (95%CI 1.8 to 2.3e+0.6), 0.05 (95%CI 0.04 to 0.08), and 39 443.88 (95%CI 30.53 to 5.1e+0.7), respectively. The AUC of SROC was 0.97 (95%CI 0.95 to 0.98). ConclusionCBCT-guided PTNB can be used as one of the primary examination approaches for lung nodules with relatively high diagnostic accuracy. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo explore the diagnostic value of CT-guided percutaneous needle aspiration biopsy (PTNB) for ground-glass opacity (GGO) pulmonary lesions. MethodsA 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. ResultsA 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). ConclusionCT-guided PTNB can be used as one of the diagnostic modalities for lung GGO lesions with a moderate diagnostic value.