Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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CT-Guided Percutaneous Transthoracic Needle Biopsy Using the Additional Laser Guidance System by a Pulmonologist with 2 Years of Experience in CT-Guided Percutaneous Transthoracic Needle Biopsy

  • Jeon, Min-Cheol (Department of Radiology, Daejeon Health Institute of Technology) ;
  • Kim, Ju Ock (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Jung, Sung Soo (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Park, Hee Sun (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Lee, Jeong Eun (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Moon, Jae Young (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Chung, Chae Uk (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Kang, Da Hyun (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Park, Dong Il (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital)
  • Received : 2017.12.03
  • Accepted : 2018.02.20
  • Published : 2018.10.31
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Abstract

Background: We developed an additional laser guidance system to improve the efficacy and safety of conventional computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB), and we conducted this study to evaluate the efficacy and safety of our system. Methods: We retrospectively analyzed the medical records of 244 patients who underwent CT-guided PTNB using our additional laser guidance system from July 1, 2015, to January 20, 2016. Results: There were nine false-negative results among the 238 total cases. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of our system for diagnosing malignancy were 94.4% (152/161), 100% (77/77), 100% (152/152), 89.5% (77/86), and 96.2% (229/238), respectively. The results of univariate analysis showed that the risk factors for a false-negative result were male sex (p=0.029), a final diagnosis of malignancy (p=0.033), a lesion in the lower lobe (p=0.035), shorter distance from the skin to the target lesion (p=0.003), and shorter distance from the pleura to the target lesion (p=0.006). The overall complication rate was 30.5% (74/243). Pneumothorax, hemoptysis, and hemothorax occurred in 21.8% (53/243), 9.1% (22/243), and 1.6% (4/243) of cases, respectively. Conclusion: The additional laser guidance system might be a highly economical and efficient method to improve the diagnostic efficacy and safety of conventional CT-guided PTNB even if performed by inexperienced pulmonologists.

Keywords

References

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