Radiology 2001 May;219(2):510-4
Percutaneous image-guided cutting-needle biopsy of the pleura in the
presence of a suspected malignant effusion.
Adams RF, Gleeson FV.
PURPOSE: To evaluate the diagnostic accuracy of percutaneous image-guided cutting-needle
biopsy of pleural thickening in the presence of a suspected malignant pleural effusion.
MATERIALS AND METHODS: Thirty-three adult patients with diffuse or focal pleural
thickening (median, 1.0 cm; range, 0.2-6.0 cm), pleural effusion, and suspected pleural
malignancy underwent percutaneous image-guided cutting-needle biopsy. Biopsy guidance was
performed with computed tomography in 24 patients and ultrasonography in nine patients. A
final diagnosis of benign or malignant disease was established with radiologic and
clinical follow-up findings and with other histologic or cytologic findings, when
available. RESULTS: A correct histologic diagnosis of malignant disease was made in 21 of
24 patients (sensitivity, 88%; specificity, 100%), including 13 of 14 patients with
mesothelioma (sensitivity, 93%). A correct histologic diagnosis of benign pleural disease
was made in nine patients. Positive and negative predictive values for malignant disease
were 100% and 75%, respectively. The overall accuracy was 91%. Complications comprised a
chest wall hematoma in one patient. CONCLUSION: Image-guided percutaneous cutting-needle
biopsy of pleural thickening in the presence of a pleural effusion is a safe procedure,
with an overall accuracy of 91% in the diagnosis of malignancy.
PMID: 11323480
