The diagnostic value of image guided percutaneous fine needle aspiration biopsy in equivocal mediastinal masses.
ABSTRACT The aim of this study was to assess the diagnostic value of image guided percutaneous fine needle aspiration (FNA) biopsy in equivocal mediastinal masses.
Sixty-six patients with an equivocal mediastinal mass who underwent FNA biopsy between 1993 and 2003 were eligible for final analysis. The cytological and definitive diagnosis of masses were grouped as primary 22 (33%)-30 (46%) and secondary (metastatic) neoplasms 18 (27%)-18 (27%) and nonneoplastic lesions 20 (30%)-18 (27%) respectively.
The diagnostic accuracy (95% C.I.) of FNA biopsy for primary mediastinal neoplasms, secondary neoplasms and nonneoplastic lesions were found to be 93.3 (83.8-98.2)%, 100 (95.1-100)%, 93.3 (83.8-98.2)%, respectively.
Image guided percutaneous FNA biopsy is a safe and highly accurate diagnostic method for equivocal mediastinal masses.
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ABSTRACT: The discovery of an anterior mediastinal mass requires careful management with specific consideration of the pathology. More than 50% of all mediastinal masses seen in adults are in the anterior mediastinum. The most frequent diagnoses are thymoma, lymphoma, teratoma and benign thyroid tumours. 60% of cases are malignant. Often the clinical and radiological findings do not allow a definitive diagnosis and a histological diagnosis is often required to select the optimal treatment modality. The choice of biopsy technique depends on the localization of the lesion, clinical factors, and the availability of special techniques and equipment. Biopsy may be obtained by trans-thoracic puncture under computed tomography or ultrasound guidance, or by a surgical approach (mediastinotomy or thoracoscopy).Revue des Maladies Respiratoires 02/2012; 29(2):138–148. · 0.49 Impact Factor
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ABSTRACT: OBJECTIVE: The objective of this study was to evaluate the diagnostic performance and safety of magnetic resonance (MR) imaging-guided percutaneous mediastinal biopsy procedures using a 0.23-T open MR system with optical tracking navigation. MATERIALS AND METHODS: A retrospective analysis of 59 participants (38 males and 21 females; mean age, 45 years; range, 16-73 years) who underwent MR imaging-guided percutaneous mediastinal biopsy procedures was performed. The access techniques included extrapleural (40 of 59; 67.8%) and transpulmonary (19 of 59; 32.2%) needle paths. Tissue sampling techniques included fine-needle aspiration (22 of 59; 37.3%) and core-needle biopsy (37 of 59; 62.7%). Histopathological analysis of surgical specimen and clinical and imaging follow-ups were used as the reference standard. The procedures were evaluated for technical success rate, number of biopsy passes, diagnostic performance, procedure time, and complications. RESULTS: Technical success was achieved in 57 of the 59 procedures (96.6%). For the fine-needle aspiration, a mean of 3 passes (range, 2-4 passes) was performed. For the core-needle biopsy, a mean of 4 passes (range, 3-6 passes) was performed. Pathological and cytological analysis of biopsy specimens showed 41 of 57 malignant lesions (71.9%) and 16 of 57 benign lesions (28.1%), with a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 93.2% (41 of 44), 100% (13 of 13), 100% (41 of 41), 81.2% (13 of 16), and 94.7% (54 of 57), respectively. Procedure time was 30 minutes (range, 20-50 minutes). Mild hemoptysis occurred in 3 cases, and in 2 cases, a small pneumothorax occurred. CONCLUSIONS: Magnetic resonance imaging-guided biopsy of mediastinal masses has a high diagnostic performance and is safe for use in clinical practice.Investigative radiology 12/2012; · 4.85 Impact Factor