Purpose: To compare the safety and efficacy of CT-guided fine needle biopsy (FNAB) of small (<15 mm) lung lesions in inpatients and outpatients.
Materials and methods: 108 consecutive inpatients (69 M, 39 F, mean age 56) and 121 consecutive outpatients (90 M, 31 F, mean age 50) who underwent CT-guided FNAB of small lung lesions were included. Lesion size, depth, number of needle passes, presence of emphysema were recorded. 22 G Chiba needles and the roll-over technique were used for all patients; if no significant pneumothorax was detected after FNAB, outpatients were allowed to go home and instructed to return in case of complications. The incidence of pneumothorax and other complications, sensitivity, specificity, diagnostic accuracy were calculated.
Results: 12 inpatients and 33 outpatients were lost to follow-up. No statistical differences were observed in lesion size, depth, needle passes, presence of emphysema between the groups. We had 15 pneumothoraces in inpatients, 4 requiring a chest tube, 12 in outpatients, 2 requiring a tube. Diagnostic accuracy was 92.7% in inpatients and 90.9% in outpatients. There were 7 false negatives in inpatients and 8 in outpatients, with negative predictive value of 79% and 78%, respectively. There were no false positives. All differences are nonsignificant.
Conclusions: CT-guided FNAB of small lung lesions is an equally safe and effective procedure in inpatients and outpatients; outpatient performance of FNAB can decrease costs.