Evaluation of risk factors of diagnostic failure in fine needle biopsy in pulmonary nodules; conventional computed tomography versus computed tomography flouroscopy

Aim of this study was to determine the risk factors of diagnostic failure of o fine needle aspiration biopsy (FNAB) procedures under the guidance of conventional computed tomography (CCT) and CT fluoroscopy (CTF) comparing their diagnostic performance by single operator in pulmonary lesions. Total of 241 patients underwent FNAB procedure (123 CCT guided and 118 CTF-guided). All pulmonary nodules were classified by size (≤10 mm, 11-20 mm, 21-30 mm and >30 mm) and diagnostic yield was calculated according to the lesion size. Independent risk factors for diagnostic performance of CCT and CTF-guided FNAB were determined using multivariate logistic regression analysis. Sensitivity, specificity, PPV, NPV, and diagnostic accuracy of CCT-guided FNAB were 88.2%, 100%, 100%, 70%, and 90.7%, respectively. For CTF-guided FNAB were 91.4%, 100%, 100%, 79.4%, and 93.5%, respectively. In multivariate logistic regression analysis, small lesions (OR 1,096; 95% CI, 1.045- 1.148 p

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Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: 4
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
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