Abstract:
PURPOSE:To retrospectively compare the sensitivity of image-guided core-needle biopsy, thoracoscopy, and thoracotomy in the diagnosis of malignant pleural mesothelioma and to retrospectively determine the incidence of needle track seeding after these procedures. MATERIALS AND METHODS:Institutional review board approval was obtained, and informed consent was not required. The study included 100 consecutive patients (81 men, 19 women; average age, 65.8 years) with pathologically proved malignant pleural mesothelioma who were treated between 1994 and 2002. A total of 23 core-needle biopsies were performed in 22 patients, and 11 of these biopsies were coupled with fine-needle aspiration biopsy. A coaxial technique was used, and biopsy was performed with fluoroscopic (12 biopsies), computed tomographic (10 biopsies), or ultrasonographic (one biopsy) guidance. Sixty-nine patients underwent surgical biopsy in the form of thoracoscopy (n = 51) and/or thoracotomy (n = 21). Patients were followed up clinically for any evidence of needle track seeding after image-guided or surgical procedures. The sensitivity of diagnostic procedures and the incidence of needle track seeding as a result of intervention were calculated. RESULTS:Sensitivity was 86% for image-guided core-needle biopsy, 94% for thoracoscopy, and 100% for thoracotomy. The incidence of needle track seeding was 4% for image-guided core-needle biopsy and 22% for surgical biopsy. CONCLUSION:Image-guided core-needle biopsy in patients with malignant pleural mesothelioma has a lower incidence of needle track seeding than surgical biopsy and has a high sensitivity for diagnosis.
journal_name
Radiologyjournal_title
Radiologyauthors
Agarwal PP,Seely JM,Matzinger FR,MacRae RM,Peterson RA,Maziak DE,Dennie CJdoi
10.1148/radiol.2412051020subject
Has Abstractpub_date
2006-11-01 00:00:00pages
589-94issue
2eissn
0033-8419issn
1527-1315pii
2412051020journal_volume
241pub_type
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