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1
Department of Radiology, Nagaoka Central General Hospital, 2-1-5 Fukuzumi-cho,
Nagaoka-city, Niigata 940-8653, Japan.
2
Department of Respiratory Medicine, Nagaoka Central General Hospital,
Naguoka-city, Niigata 940-8653, Japan.
3
Department of Thoracic Surgery, Nagaoka Central General Hospital,
Naguoka-city, Niigata 940-8653, Japan.
OBJECTIVE. The purpose of this study was to determine the factors influencing diagnostic accuracy in CT-guided automated needle biopsies of lung nodules.
SUBJECTS AND METHODS. One hundred thirty-eight consecutive CT-guided automated needle biopsy procedures were performed in 123 patients (124 pulmonary nodules). Factors for diagnostic accuracy were evaluated through analysis of the procedures, which were classified into a success group (true-positive and true-negative) and a failure group (false-positive and false-negative).
RESULTS. Final diagnoses were 81 malignant lesions (91 biopsies) and 43 benign lesions (47 biopsies). More than two CT-guided biopsies were performed for 13 lesions. Seventy lesions were true-positive, 44 were true-negative, three were false-positive, and 21 were false-negative. The overall diagnostic accuracy was 82.6%. The sensitivity for malignancy and specificity for benign lesions were 76.9% and 93.6%, respectively. Positive and negative predictive values were 95.9% and 67.7%, respectively. Lesion size was a significant factor contributing to diagnostic accuracy (p = 0.014). Mean diameters of lesions (±SD) in the success and failure groups were 24.1 ± 12.4 mm and 17.6 ± 7.8 mm, respectively. For lesions 6-10 mm in diameter, diagnostic accuracy was 66.7%; for lesions 11-20 mm in diameter, 78.9%; for lesions 21-30 mm in diameter, 86.7%; for lesions 31-50 mm in diameter, 93.3%; and for lesions 51-70 mm in diameter, 100%.
CONCLUSION. Lesion size was a determining factor in diagnostic accuracy. Diagnostic accuracy decreased in proportion to the decrease in the lesion diameter.
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