Computed tomography-guided transthoracic needle aspiration biopsy of intrapulmonary lesions: utility of a liquid-based cytopreparatory technique

Acta Cytol. 2008 Nov-Dec;52(6):665-70. doi: 10.1159/000325619.

Abstract

Objective: To determine if a ThinPrep processor (Cytyc Corporation, Boxborough, Massachusetts, U.S.A.) could be used to improve diagnostic accuracy in the absence of a cytopathologist at the time of computed tomography-guided (CT-guided) transthoracic needle aspiration biopsy (TNAB) of the lung.

Study design: Ninety-two patients (59 men and 33 women who were 26-85 years old) underwent CT-guided TNAB. The aspirated specimen was prepared with the ThinPrep cytopreparatory technique for cytologic evaluation. The final histologic diagnoses were based on the pathologic material obtained from a cutting needle biopsy, bronchoscopic biopsy and surgical excision and the on clinical follow-up (mean, 12 months). On this basis, the accuracy, sensitivity and specificity of TNAB for malignant lesions were calculated by comparing the diagnoses obtained from percutaneous transthoracic needle aspiration with the final diagnoses using a chi2 test. was made, 56 (60.9%) were malignant and 36 (39.1%) benign. The diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value for the diagnosis of malignancy were 92%, 87.5%, 100%, 100% and 80%, respectively.

Conclusion: CT-guided TNAB using ThinPrep provided excellent diagnostic accuracy and was useful because this technique shows less air-drying artifact and can separate cells and blood clots on the slides.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Needle / methods*
  • Chi-Square Distribution
  • Female
  • Humans
  • Lung Diseases / diagnostic imaging
  • Lung Diseases / pathology*
  • Male
  • Middle Aged
  • Prospective Studies
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / methods*