Title:The Diagnostic Value of CT-guided Percutaneous Co-axial Trans-thoracic Biopsy (PCTTB) and Evaluation of the Pathologic Examination
VOLUME: 15 ISSUE: 5
Author(s):Mehmet Hamdi Şahan, Mikail Inal, Nuray Bayar Muluk*, Adil Doğan and Pınar Atasoy
Affiliation:Department of Radiology, Faculty of Medicine, Kirikkale University, Kirikkale, Department of Radiology, Faculty of Medicine, Kirikkale University, Kirikkale, ENT Department, Faculty of Medicine, Kirikkale University, Kirikkale, Radiology Department, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Pathology Department, Faculty of Medicine, Kirikkale University, Kirikkale
Keywords:Lung mass, malign, squamous cell carcinoma, adenocarcinoma, metastasis, complications, pneumothorax,
hemorrhage, hemoptysis.
Abstract:
Background: We investigated thoracic masses with Computed Tomography (CT)-
guided Percutaneous Co-Axial Trans-Thoracic Biopsy (PCTTB).
Methods: The retrospective data of 86 patients to whom CT-guided PCTTB had been applied were
obtained. Eighty-four cases and their pathologic results were included in the study. Localization
and appearance of the lesions, pathologic results, and complications were evaluated.
Results: Diagnostic sensitivity of CT-guided PCTTB was 97.6%. In 60.7% of the cases, malign
lesions and, in 39.3% of the cases, benign lesions were diagnosed. The mass size was on average
greater than 2 cm, and one mass was detected as being more than ≥2 masses. Mainly, irregular contours
were observed. Most of the malign tumors were primary malign tumors on both sides (91.7%
on the right side and 88.9% on the left side). Squamous Cell Carcinoma (SCC) was the most often
detected malign tumor on the right side, and adenocarcinoma was the most often detected malign
tumor on the left side. In masses localized on the left inferior lobe, metastasis was often detected.
When the number of the mass was ≥2 and the mass had the appearance of consolidation, metastasis
was usually detected. Small and large masses were mainly localized on right and left upper lobes.
In the small mass group, 75.0% of the cases were benign, and, in the large mass group, 64.5% of
the cases were malign (p=0.031, χ2=4.666). Pneumothorax was the most commonly occurring
complication (23.8%). In masses localized on the right lower lobe, the pneumothorax ratio increased
in benign masses compared to malign masses. The hemorrhage detection rate was 13.0%,
and hemoptysis occurred in 14.2% of the cases. Hemorrhage was detected during 11.8% of the
large mass biopsies. In females, hemorrhage occurred more often than in males (p=0.026,
r= 0.244).
Conclusion: CT-guided PCTTB is a safe method to utilize for lung biopsies. Co-axial method increased
the diagnostic accuracy of CT-guided percutaneous trans-thoracic biopsies. A single cut
also decreased the complication rates.
