Sensitivity and specificity of computed tomography (CT)-guided transthoracic needle aspiration biopsy for diagnosis of localized pulmonary and mediastinal lesion,First 3 years at Prapokklao Hospital.

Abstract

Background : Computed tomography(CT)-guided transthoracic needle aspiration biopsy (CTguided TTNA) was one of standard investigations for diagnosis of localized pulmonary and mediastinal lesions. This method was first used at Prapokklao Hospital about 3 years ago. However, its sensitivity and specificity has never been evaluated.

Method : Data of all patients who undergone CT-guided TTNA at Prapokklao Hospital from May 2003 to April 2006 were retrospectively reviewed. Software program was used to analyze sensitivity, specificity, and rate of complications of CT-guided TTNA.

Result : A total of thirty-seven aspirates of CT-guided TTNA from 34 cases were reviewed. Most patients were male (26 patients), old age (mean aged 65.5 years old), and smokers (0-20 pack-year). The most presentation symptoms were weight loss (52.9 percent), followed by cough (41.2 percent). Mean duration of symptoms was 8.4 weeks. Pulmonary mass (85.3 percent) was the most common finding of
chest imaging (chest X-ray or CT chest). Definite diagnosis was obtained by 29 out of 37 times study (78.3 percent) of CT-guided TTNA. Adenocarcinoma was the most common diagnosis. Sensitivity and specificty for diagnosis were 85.2 percent and 100 percent, repectively. This finding showed that this method yields highly accurate results for diagnosis of malignancy lesions. There was only one complication,
pneumothorax, occurred in one patient.

Conclusion : CT-guided TTNA is a simple, rapid, safe investigative procedure that can provide definite diagnosis for localized pulmonary and mediastinal lesions.