Source: Annual Congress 2002 - Lung cancer: epidemiology and clinical characteristics
Disease area: Thoracic oncology

Abstract

Transbronchial biopsy (TBx) performed with the aid of fluoroscopy may improve the diagnostic yeld of fiberopticbronchoscopy (FOB) in the diagnosis of periheral lung nodules, reaching a sensitivity of 64% [Shiner R.J. et al. Thorax 1988, 43: 887-889]. We tried to further improve our yeld combining FOB with the technique of the modern digital x-ray. Methods. In patients with peripheral lung nodules, we perform FOB on the digital x-ray table of the angiographic room. After we have approached the segmental bronchus driving to the nodule, we push out the forcep toward the nodule and the image is frozen on a monitor, then the objective is rotated 90° and the lateral vision of the chest is offered us to verify the position. If it is satisfactory, we proceed to the biopsy which is usualy repeated many times.We revised the case records of all patients who underwent TBx and/or computerized tomography guided transthoracic needle biopsy (CT Nx) in our hospital during 2001. Sensitivity, specificity, positive and negative predictive values (PPV, NPV) have been calculated for both methods. Results. Thirtyfour patients underwent CT Nx (5 patients repeated it twice) and 20 underwent TBx. Four out of these 54 patients underwent both, and only one of them remained without histological diagnosis. All positive biopsies received a surgical and/or clinical confirmation. Thirtyfour were NSCLC, 4 SCLC and one was a benign tumor. Both methods showed a 100% specificity and PPV. Sensitivity was 82% for TBx and 70% for CT Nx. NPV was 78% for TBx and 56% for CT Nx. Only two patients, one for each method, had a late pneumothorax.

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G. E. Anzalone, U. Bongini, A. Gori, F. Rubini, M. C. Truglia, S. Bayon, R. Fargnoli (Prato, Italy). Comparison between computerized tomography guided transthoracic needle biopsy and transbronchial biopsy under the guide of a digital x-ray system for the diagnosis of peripheral lung nodules. Eur Respir J 2002; 20: Suppl. 38, 570

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