naa a22 4500 510747434 CHVBK 20180411083051.0 cr unu---uuuuu 180411e20131001xx s 000 0 eng 10.1007/s11547-013-0965-4 doi (NATIONALLICENCE)springer-10.1007/s11547-013-0965-4 Predictive factors of diagnostic accuracy of CT-guided transthoracic fine-needle aspiration for solid noncalcified, subsolid and mixed pulmonary nodules [Elektronische Daten] [Massimo De Filippo, Luca Saba, Giorgio Concari, Rita Nizzoli, Lilia Ferrari, Marcello Tiseo, Andrea Ardizzoni, Nicola Sverzellati, Ilaria Paladini, Chiara Ganazzoli, Luca Sconfienza, Giampaolo Carrafiello, Luca Brunese, Eugenio Genovese, Luca Ampollini, Paolo Carbognani, Michele Rusca, Maurizio Zompatori, Cristina Rossi] Fattori che predicono l'accuratezza diagnostica dell'agobiopsia transtoracica TC-guidata dei noduli polmonari solidi non calcifici, subsolidi e misti Purpose: The aim of this study was to analyse factors predicting the diagnostic accuracy of computed tomography (CT)-guided transthoracic fine-needle aspiration (TTFNA) for solid noncalcified, subsolid and mixed pulmonary nodules, with particular attention to those responsible for false negative results with a view to suggesting a method for their correction. Materials and methods: From January 2007 to March 2010, we retrospectively reviewed the CT images of 198 patients of both sexes (124 males and 74 females; mean age, 70 years; range age, 44-90) used for the guidance of TTFNA of pulmonary nodules. Aspects considered were: lesion size and density, distance from the pleura, and lesion site. Multiplanar reformatted images (MPR) were retrospectively obtained in the sagittal and axial oblique planes relative to needle orientation. Results: The overall diagnostic accuracy of TTFNA CTguided biopsy was 86% for nodules between 0.7 and 3 cm, 83.3% for those between 0.7 and 1.5 cm, and 92% for those between 2 and 3 cm. Accuracy was 95.1% for solid pulmonary nodules, 84.6% for mixed nodules, and 66.6% for subsolid nodules. The diagnostic accuracy of CT-guided TTFNA in relation to the distance between the nodule and the pleural plane was 95.6% for lesions adhering to the pleura and 83.5% for central ones. The diagnostic accuracy was 84.2% for the pulmonary upper lobe nodules, 85.3% for the lower lobe and 90.9% for those in the lingula and middle lobe. In 75% of false negative and inadequate/insufficient cases the needle was found to lie outside the lesion, after reconstruction of the needle path by MPR. Conclusions: The positive predictive factors of CT-guided TTFNA are related to the nodule size, density and distance from the pleural plane. The most common negative predictive factor of CT-guided TTFNA is the wrong position of the needle tip, as observed in the sagittal and axial oblique sections of the MPR reconstructions. The diagnostic accuracy of CT-guided TTFNA can therefore be improved by using the MPR technique to plan the needle path during the FNA procedure. Springer-Verlag, 2013 Lung nodule nationallicence Multiplanar reformatting nationallicence MPR nationallicence Trans-thoracic fine needle aspiration, TTFNA nationallicence CT-guided biopsy nationallicence Predictive diagnostic factors nationallicence Nodulo polmonare nationallicence Ricostruzione multiplanare nationallicence Ago-biopsia trans-toracica nationallicence Biopsia TCguidata nationallicence Fattori diagnostici predittivi nationallicence De Filippo Massimo Radiology Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut Saba Luca Radiology Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut Concari Giorgio Radiology Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut Nizzoli Rita Department of Oncology, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut Ferrari Lilia Pneumology Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut Tiseo Marcello Department of Oncology, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut Ardizzoni Andrea Department of Oncology, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut Sverzellati Nicola Radiology Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut Paladini Ilaria Radiology Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut Ganazzoli Chiara Radiology Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut Sconfienza Luca Radiology Unit, IRCCS Policlinico San Donato, Piazza E. Malan 2, 20097, San Donato Milanese, Milan, Italy aut Carrafiello Giampaolo Radiology Unit, University Hospital, Varese Hospital, Viale Borri 57, 21100, Varese, Italy aut Brunese Luca Medicine and Health Sciences Unit, Molise University, Campobasso, Italy aut Genovese Eugenio Medical Sciences Unit, Cagliari University Hospital, Cagliari, Italy aut Ampollini Luca Thoracic Surgery Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut Carbognani Paolo Thoracic Surgery Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut Rusca Michele Thoracic Surgery Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut Zompatori Maurizio Radiology Unit, S. Orsola University Hospital, Via Massarenti 9, 40138, Bologna, Italy aut Rossi Cristina Radiology Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut La radiologia medica Springer-Verlag 118/7(2013-10-01), 1071-1081 0033-8362 118:7<1071 2013 118 11547 https://doi.org/10.1007/s11547-013-0965-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11547-013-0965-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- De Filippo Massimo Radiology Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Saba Luca Radiology Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Concari Giorgio Radiology Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Nizzoli Rita Department of Oncology, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Ferrari Lilia Pneumology Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Tiseo Marcello Department of Oncology, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Ardizzoni Andrea Department of Oncology, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Sverzellati Nicola Radiology Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Paladini Ilaria Radiology Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Ganazzoli Chiara Radiology Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Sconfienza Luca Radiology Unit, IRCCS Policlinico San Donato, Piazza E. Malan 2, 20097, San Donato Milanese, Milan, Italy aut NATIONALLICENCE 700 1- Carrafiello Giampaolo Radiology Unit, University Hospital, Varese Hospital, Viale Borri 57, 21100, Varese, Italy aut NATIONALLICENCE 700 1- Brunese Luca Medicine and Health Sciences Unit, Molise University, Campobasso, Italy aut NATIONALLICENCE 700 1- Genovese Eugenio Medical Sciences Unit, Cagliari University Hospital, Cagliari, Italy aut NATIONALLICENCE 700 1- Ampollini Luca Thoracic Surgery Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Carbognani Paolo Thoracic Surgery Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Rusca Michele Thoracic Surgery Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Zompatori Maurizio Radiology Unit, S. Orsola University Hospital, Via Massarenti 9, 40138, Bologna, Italy aut NATIONALLICENCE 700 1- Rossi Cristina Radiology Unit, University of Parma, Parma Hospital, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 773 0- La radiologia medica Springer-Verlag 118/7(2013-10-01), 1071-1081 0033-8362 118:7<1071 2013 118 11547 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer