Objective: To evaluate variables that could predict diagnosis during CT-guided fine-needle aspiration. Methods: Data from 249 patients who underwent FNAB from January 2010 to December 2012 were analyzed in a retrospective observational study. Results: Mean age was 66.7 ± 11.5 years, male/female ratio 158/91 (63 vs. 37 %). The nodules were in right lung in 123 patients (49 %), in left lung in 126 patients (51 %), the upper, lower and middle lobe localizations were, respectively in 122 (49 %), 100 (40 %) and 17 (6 %) patients. Mean nodule-chest wall distance was 63.89 ± 21.38 mm. The tumor location, the needle diameter, the presence of necrosis or cavitation, the node-chest wall distance and the number of passages were not related to the diagnostic outcome (p = NS). The nodule diameter was predictive of diagnosis. Odds ratio for a 10-30 mm tumor was 2.51 (95 % OR: 1.24–5.08, p value = 0.011), the odds ratio for a 30–50 mm tumor was 2.39 (95 % OR: 1.22–4.69, p value = 0.011), and the odds ratio for a tumor larger than 50 mm was 4.44 (95 % OR: 1.89–10.44, p value = 0.001). Post-procedure pneumothorax occurred in 62 cases (25 %). The determinant factors for pneumothorax occurrence were emphysema, odds ratio 6.87 (95 % CI 1.07–44.10, p value = 0.04), and the number of pleural passages, odds ratio of 5.47 (95 % OR: 1.92–15.58), 7.44 (95 % OR: 2.58–21.5), 6.13 (95 % OR: 2.07–18.11) p value = 0.001 for one, two, three or more of three passages, respectively. Conclusions: In our experience, nodule size is the most important diagnostic factor during fine-needle aspiration, while the number of passages and the presence of emphysema constitute risk factors for pneumothorax occurrence.

Chiappetta, M., Rosella, F., Dall’armi, V., Pomes, L. M., Petracca Ciavarella, L., Nachira, D., Pirronti, T., Margaritora, S., Granone, P., CT-guided fine-needle ago-biopsy of pulmonary nodules: predictive factors for diagnosis and pneumothorax occurrence, <<LA RADIOLOGIA MEDICA>>, 2016; 121 (8): 635-643. [doi:10.1007/s11547-016-0639-0] [http://hdl.handle.net/10807/92068]

CT-guided fine-needle ago-biopsy of pulmonary nodules: predictive factors for diagnosis and pneumothorax occurrence

Chiappetta
;
Marco; Rosella
Secondo
;
Leda Marina; Petracca Ciavarella;Leonardo; Nachira;Dania; Pirronti;Tommaso; Margaritora
Penultimo
;
Stefano; Granone
Ultimo
2016

Abstract

Objective: To evaluate variables that could predict diagnosis during CT-guided fine-needle aspiration. Methods: Data from 249 patients who underwent FNAB from January 2010 to December 2012 were analyzed in a retrospective observational study. Results: Mean age was 66.7 ± 11.5 years, male/female ratio 158/91 (63 vs. 37 %). The nodules were in right lung in 123 patients (49 %), in left lung in 126 patients (51 %), the upper, lower and middle lobe localizations were, respectively in 122 (49 %), 100 (40 %) and 17 (6 %) patients. Mean nodule-chest wall distance was 63.89 ± 21.38 mm. The tumor location, the needle diameter, the presence of necrosis or cavitation, the node-chest wall distance and the number of passages were not related to the diagnostic outcome (p = NS). The nodule diameter was predictive of diagnosis. Odds ratio for a 10-30 mm tumor was 2.51 (95 % OR: 1.24–5.08, p value = 0.011), the odds ratio for a 30–50 mm tumor was 2.39 (95 % OR: 1.22–4.69, p value = 0.011), and the odds ratio for a tumor larger than 50 mm was 4.44 (95 % OR: 1.89–10.44, p value = 0.001). Post-procedure pneumothorax occurred in 62 cases (25 %). The determinant factors for pneumothorax occurrence were emphysema, odds ratio 6.87 (95 % CI 1.07–44.10, p value = 0.04), and the number of pleural passages, odds ratio of 5.47 (95 % OR: 1.92–15.58), 7.44 (95 % OR: 2.58–21.5), 6.13 (95 % OR: 2.07–18.11) p value = 0.001 for one, two, three or more of three passages, respectively. Conclusions: In our experience, nodule size is the most important diagnostic factor during fine-needle aspiration, while the number of passages and the presence of emphysema constitute risk factors for pneumothorax occurrence.
Inglese
Chiappetta, M., Rosella, F., Dall’armi, V., Pomes, L. M., Petracca Ciavarella, L., Nachira, D., Pirronti, T., Margaritora, S., Granone, P., CT-guided fine-needle ago-biopsy of pulmonary nodules: predictive factors for diagnosis and pneumothorax occurrence, <<LA RADIOLOGIA MEDICA>>, 2016; 121 (8): 635-643. [doi:10.1007/s11547-016-0639-0] [http://hdl.handle.net/10807/92068]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/92068
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