The utility of ultrasound-guided percutaneous needle biopsy for diagnosis of peripheral pulmonary lesions: A retrospective cohort study.

Abstract

Objective: The aim of this study was to explore the diagnostic accuracy of ultrasound-guided (US-guided) percutaneous needle biopsy (PNB) and related influencing factors that could provide references for clinicians to improve the diagnostic accuracy of peripheral pulmonary lesions (PPLs).

Methods: We retrospectively analyzed 318 consecutive cases with PPLs who underwent US-guided PNB successfully in Chongqing Red Cross Hospital, Fusheng Community Health Service Center, Maoershi Community Health Service Center, and Yuzui Community Health Service Center. We collected pathological results of ultrasound-guided biopsy, clinical final diagnosis, disease course records, and postoperative complications of these patients. According to whether the pathological diagnosis of biopsy of US-guided PNB was consistent with the final clinical diagnosis, it can be divided into true positive, false positive, true negative, and false negative to calculate diagnostic yield. The factors affecting the diagnostic accuracy were assessed between diagnosed cases (true positive and true negative) and non-diagnosed cases (false negative and uncertain) by the Chi-Square test.

Results: Among the 318 patients, 292 cases had determinate pathological diagnosis through US-guided PNB and 26 cases were indeterminate. The diagnostic yield including diagnostic accuracy, sensitivity, specificity, positive-predictive value, and negative predictive value in 318 patients under US-guided PNB was 86.2%, 73.8%, 85.2%, 82.7%, and 77.3%, respectively. The total complication rate was 6.0%. After analyzing multiple factors during the biopsy process, we found that the size of lesion had a significant impact on the diagnostic accuracy of US-guided PNB.

Conclusion: Ultrasound-guided percutaneous needle biopsy has a high success rate and diagnostic accuracy, which is an effective and accurate method for the diagnosis of peripheral lung diseases. The size of lesions can affect the diagnostic accuracy.