1. Diagnostic success of transthoracic needle biopsy and PET-CT for 1 to 2 cm solid indeterminate pulmonary nodules.
- Author
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Susam S, Çinkooğlu A, Ceylan KC, Gürsoy S, Kömürcüoğlu BE, Mertoğlu A, Çırak AK, Tuksavul F, Gayaf M, Güldaval F, Polat G, Yıldırım E, Koparal H, and Yücel N
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Reproducibility of Results, Retrospective Studies, Sensitivity and Specificity, Solitary Pulmonary Nodule pathology, Unnecessary Procedures statistics & numerical data, Biopsy methods, Biopsy, Fine-Needle methods, Lung pathology, Positron Emission Tomography Computed Tomography methods, Solitary Pulmonary Nodule diagnostic imaging
- Abstract
Objectives: Among the nodule types, the most controversial group are indeterminate solid nodules from 1 to 2 cm in size with the first choice being transthoracic needle biopsy (TTNB) or positron emission tomography (PET-CT) or both methods together. However, no single diagnostic algorithm could be applied to all cases. This research discusses the diagnostic success of PET-CT and TTNB., Materials and Methods: 407 Patients who referred to our hospital for any reason, with solid nodules with the size from 1 to 2 cmincidentally identified on the thoracic CT tests were investigated. Among the patients who underwent biopsy, 312 cases had PET-CT, and maximum SUV (SUVmax) values of the nodules were examined. Values of ≥2.5 were accepted as hypermetabolic., Results: The mean age of the patients was 61 ± 10.8 years. 84 patients were female (20.6%) and 323 were male (79.4%). For TTNB; sensitivity, specificity and accuracy rates of all cases, who were correctly diagnosed, were 76.9%, 83.3% and 78.9%, respectively (P < .001). The 2.5 SUVmax cutoff value had sensitivity of 91%, specificity of 35.6%, accuracy of 75% (P = .034). The cutoff value of 49 years of age, nodule size of 16.4 mm, gender and 2.5 SUVmax value had high accuracy for benign-malignant differentiation. No statistically significant difference was found in the upper lobe localization of nodule., Conclusion: A positive result from TTNB is a reliable finding; however, a negative result is not definitive. The high negative predictive value of PET-CT is effective in preventing the unnecessary biopsies and surgical procedures., (© 2020 John Wiley & Sons Ltd.)
- Published
- 2020
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