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CT assessment-based direct surgical resection of part-solid nodules with solid component larger than 5 mm without preoperative biopsy: experience at a single tertiary hospital
- Source :
- European Radiology. 27:5119-5126
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- To retrospectively evaluate the feasibility of CT assessment-based direct surgical resection of part-solid nodules (PSNs) with solid components > 5 mm without preoperative percutaneous transthoracic needle biopsies (PTNBs). From January 2009–December 2014, 85 PSNs with solid components > 5 mm on CT were included. Preoperative PTNBs were performed for 41 PSNs (biopsy group) and CT assessment-based direct resections were performed for 44 PSNs (direct surgery group). Diagnostic accuracy and complication rates of the groups were compared. Pathological results of 83 PSNs excluding two indeterminate nodules included 76 adenocarcinomas (91.6%), two adenocarcinomas in situ (2.4%) and five benign lesions (6.0%). In the biopsy group, the overall sensitivity, specificity and accuracy for the diagnosis of adenocarcinoma were 78.9% (30/38), 100% (1/1) and 79.5% (31/39), respectively. Pneumothorax and haemoptysis occurred in 11 procedures (26.8%). In the direct surgery group, the respective values for the diagnosis of adenocarcinoma were 100% (38/38), 0% (0/6) and 86.4% (38/44), respectively. Seven pneumothoraces (15.9%); no haemoptysis occurred during localization procedures. There were no significant differences in diagnostic accuracy (P = 0.559) between the two groups. CT assessment-based direct resection can be reasonable for PSNs with solid part > 5 mm. • 91.6% of PSNs with solid component > 5 mm were adenocarcinomas. • PTNBs for PSNs with solid component > 5 mm had 79.5% accuracy. • CT-based resection for PSNs with solid component > 5 mm had 86.4% accuracy. • CT-based resection without biopsy can be a reasonable option in routine practice.
- Subjects :
- Adult
Male
medicine.medical_specialty
Lung Neoplasms
Percutaneous
Adenocarcinoma
Sensitivity and Specificity
030218 nuclear medicine & medical imaging
Tertiary Care Centers
03 medical and health sciences
0302 clinical medicine
Biopsy
medicine
Humans
Radiology, Nuclear Medicine and imaging
Aged
Retrospective Studies
Neuroradiology
Aged, 80 and over
Solitary pulmonary nodule
medicine.diagnostic_test
business.industry
Pneumothorax
Solitary Pulmonary Nodule
Interventional radiology
General Medicine
Middle Aged
medicine.disease
030220 oncology & carcinogenesis
Feasibility Studies
Female
Radiology
Tomography, X-Ray Computed
Complication
business
Subjects
Details
- ISSN :
- 14321084 and 09387994
- Volume :
- 27
- Database :
- OpenAIRE
- Journal :
- European Radiology
- Accession number :
- edsair.doi.dedup.....f0576e6759cbb60b2f794230d53eefd9