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Diagnostic Accuracy of CT-Guided Core Biopsy of Ground-Glass Opacity Pulmonary Lesions

¹ Department of Radiology, Seoul National University Bundang Hospital; Seoul National University College of Medicine; and Institute of Radiation Medicine, Seoul National University Medical Research Center; 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Korea.
² Department of Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Gyeonggi-do, Korea.
³ Department of Thoracic Surgery, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Gyeonggi-do, Korea.
⁴ Department of Pathology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Gyeonggi-do, Korea.

OBJECTIVE. The purpose of our study was to evaluate the accuracy of CT-guided percutaneous core biopsy of ground-glass opacity (GGO) pulmonary lesions.

MATERIALS AND METHODS. The study included 50 patients (24 men, 26 women; age range, 43-78 years) who had a GGO pulmonary lesion and underwent CT-guided core biopsy. Diagnostic accuracy was compared between two groups according to lesion size (< 2 cm vs 2 cm) and GGO component (> 90% vs 50-90%). Each case was reviewed for complications, including pneumothorax, thoracostomy tube insertion, and hemoptysis.

RESULTS. Malignancy was finally diagnosed in 33 patients, including three who underwent repeated biopsies, with 33 true-positive and three false-negative findings for an overall sensitivity of 92% (33/36). A benign lesion was finally diagnosed in 10 patients with one false-positive result, for a specificity of 90%. Two benign lesions without confirmative diagnosis because of loss of follow-up and five nondiagnostic samples were excluded from the calculations of sensitivity, specificity, and diagnostic accuracy. The overall diagnostic accuracy was 91%, with a positive predictive value of 97% and a negative predictive value of 75%. Sensitivity and accuracy were not significantly different between the two groups of lesion size and GGO components (p = 0.0491). Ten (18%) patients had pneumothorax, with one (2%) requiring placement of a thoracostomy tube. Mild hemoptysis occurred in seven (13%) patients.

CONCLUSION. CT-guided core biopsy of GGO lesions can yield high diagnostic accuracy and acceptable complication rates approaching those of solid lesions.

Keywords: core biopsy • CT • diagnostic accuracy • ground-glass opacity • lung

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