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Evolution of transthoracic fine needle aspiration and core needle biopsy practice: A comparison of two time periods, 1996–1998 and 2003–2005
Author(s) -
Minot Douglas M.,
Jaben Elizabeth,
Aubry MarieChristine,
Voss Jesse S.,
Vine Roanna L.,
Lee Peter U.,
Carlson Stephanie K.,
Clayton Amy C.
Publication year - 2012
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.21666
Subject(s) - medicine , cohort , fine needle aspiration , biopsy , retrospective cohort study , radiology , gold standard (test) , predictive value , lung cancer , predictive value of tests , nuclear medicine , surgery
To examine the performance of our large pulmonary transthoracic fine needle aspiration/core biopsy (FNA/CB) practice over time, we performed a retrospective analysis of data from 333 consecutive procedures performed in 1996–1998 and 568 consecutive procedures performed in 2003–2005. Fluoroscopic guidance was performed more frequently in the earlier cohort, while a larger majority of procedures in the later cohort were by computed tomography (CT‐guidance). A follow‐up histologic diagnosis of cancer or clinical evidence of disease was considered the gold‐standard. FNA/CB procedures during the later time period were performed on smaller lesions overall (3.60 cm versus 2.97 cm; P = 0.003) and malignant lesions also tended to be smaller (3.87 cm versus 3.14 cm; P = 0.006). Minimal improvements in sensitivity (94% versus 91%), specificity (99% versus 95%), diagnostic accuracy (95% versus 92%), negative predictive value (NPV) (80% versus 74%), and positive predictive value (PPV) (100% versus 99%) were noted during 2003–2005 when compared with 1996–1998 in all lesions. Larger improvements in sensitivity (94% versus 73%), diagnostic accuracy (95% versus 79%), and NPV (79% versus 50%) were identified in very small lesions (<1 cm) in the later patient cohort in comparison to the earlier patient cohort, as well as a significant decrease in total procedure complications. CT‐guided transthoracic FNA/CB continues to be a very effective tool in our practice assessing lung lesions and performance has improved considerably at our institution for very small lesions. Diagn. Cytopathol. 2012. © 2011 Wiley Periodicals, Inc.