Jl. Swischuk et al., PERCUTANEOUS TRANSTHORACIC NEEDLE-BIOPSY OF THE LUNG - REVIEW OF 612 LESIONS, Journal of vascular and interventional radiology, 9(2), 1998, pp. 347-352
PURPOSE: The results and complications of 651 pulmonary fine-needle as
piration biopsies (FNABs) were reviewed. The number of needle passes a
nd needle size were correlated to pneumothorax and chest tube placemen
t rates. MATERIALS AND METHODS: FNAB of the lung was performed on 651
occasions in 612 patients with 18- to 22-gauge Franseen needles. Diagn
ostic rates were calculated, The number of needle passes performed and
needle size used were evaluated for their association with pneumothor
ax and subsequent chest tube placement. RESULTS: Diagnostic accuracy w
as 94% with sensitivity for malignancy of 95%. Positive and negative p
redictive values were 99.5% and 90%, respectively, Pneumothorax occurr
ed in 26.9% of patients with 9.2% requiring chest tube placement. Incr
easing numbers of needle passes and larger needle sizes did not increa
se the rates of pneumothorax or chest tube placement. CONCLUSIONS: FNA
B of the lung has excellent diagnostic rates and remains the procedure
of choice for diagnosing pulmonary lesions. This large study contradi
cts perceptions that pneumothorax and chest tube placement rates decre
ase with thinner needles and fewer passes.