Non-specific benign pathological results on transthoracic core-needle biopsy: how to differentiate false-negatives?

Objectives: To determine the negative predictive value (NPV) of non-specific benign results from cone-beam CT (CBCT)-guided transthoracic core-needle biopsy (TTNB) and identify predicting factors for false-negative for malignancies.Methods: From January 2009-December 2011, 1,108 consecutive patients...

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Publicado en:European Radiology Vol. 27; no. 9; pp. 3888 - 3896
Autores principales: Kim, Jung, Park, Chang, Kim, Hyungjin, Lee, Jong, Goo, Jin, Kim, Jung Im, Park, Chang Min, Lee, Jong Hyuk, Goo, Jin Mo
Formato: diagnostic images research tables/charts Journal Article
Publicado: Springer Nature Sep2017
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Non-specific benign pathological results on transthoracic core-needle biopsy: how to differentiate false-negatives?
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        au:
          Kim, Jung
          Park, Chang
          Kim, Hyungjin
          Lee, Jong
          Goo, Jin
          Kim, Jung Im
          Park, Chang Min
          Lee, Jong Hyuk
          Goo, Jin Mo
        affil: Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine , Seoul National University Medical Research Center , 101, Daehangno, Jongno-gu Seoul 110-744 Korea
      sug:
        subj:
          Lung Neoplasms Pathology
          Lung Pathology
          False Negative Results
          Aged, 80 and Over
          Specialties, Medical
          Retrospective Design
          Needles
          Male
          Adult
          Granuloma Pathology
          Pneumonia Pathology
          Aged
          Tomography, X-Ray Computed Methods
          Middle Age
          Female
          Biopsy Methods
          Biopsy, Needle Methods
          Human
          Aged, 80 & over
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Objectives: To determine the negative predictive value (NPV) of non-specific benign results from cone-beam CT (CBCT)-guided transthoracic core-needle biopsy (TTNB) and identify predicting factors for false-negative for malignancies.Methods: From January 2009-December 2011, 1,108 consecutive patients with 1,116 lung lesions underwent CBCT-guided TTNB using an 18-gauge coaxial cutting needle. Among them, 226 patients with 226 TTNBs, initially diagnosed as non-specific benign, were included in this study. The medical charts, radiological or pathological follow-ups were reviewed to classify false-negative and true-negative results and to identify which variables were associated with false-negatives.Results: Of 226 lesions, 24 (10.6%) were finally confirmed as malignancies and 202 (89.4%) as benign, of which the NPV was 89.4% (202/226). Multivariate analysis revealed that part-solid nodule (PSN) (odds ratio (OR), 3.95; P = 0.022), a biopsy result of 'granulomatous inflammation' (OR, 0.04; P = 0.022), and exact location of needle tip within targets (OR, 0.37; P = 0.045) were significantly associated with false-negatives among initial non-specific benign biopsy results.Conclusion: The NPV of the non-specific benign biopsy was 89.4%. PSN was a significant positive indicator, but a biopsy result of 'granulomatous inflammation' and exact location of needle tip within targets were significant negative indicators for false-negatives.Key Points: • The negative predictive value of the non-specific benign biopsy was 89.4%. • A part-solid nodule is a significant predictor for false-negative biopsy (OR = 3.95). • Pathological diagnosis of granulomatous inflammation is a robust indicator for 'true-negatives'. • Identifying needle tip within target lesions is a significant predictor for 'true-negatives'.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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