Evaluating the Diagnostic Yield of CT Guided Biopsy and FNAC in a Tertiary Care Hospital
Journal Title: International Journal of Contemporary Medicine surgery and Radiology - Year 2018, Vol 3, Issue 1
Abstract
Introduction: CT guided core biopsy and FNA are accepted standard techniques for tissue access in chest and abdominal lesions with good diagnostic yields. Aims: To evaluate the diagnostic yield and complications of CT guided core biopsy and FNA in chest and abdominal lesions and to compare the yield based on the technique and experience of the radiologist. Material and methods: This is a retrospective analysis of 380 patients (mean age 61, male: female - 80:20) CT guided biopsies and FNA done in our hospital between Jan 2014 – Dec 2017 using standard techniques and materials. 307 of 380 cases (80.7%) were from the thoracic sites and 256 of 380 cases (67.3%) were from the lung parenchymal lesions. 255 of 380 patients (67%) underwent CT guided core needle biopsy and 125 of 380 patients (33%) underwent FNA. 285 of 380 CT guided procedures (75%) were performed by senior radiologist with more than 5yrs experience and 95 of 380 (25%) were performed by junior radiologists. Results: Overall diagnostic yield of the study was 83.94%, i.e. in 319 of 380 patients. The yield for core biopsies was better at 87% as against 77.6% for FNA (p= 0.0193). The yield was better for procedures performed by senior radiologists at 87.02% as against 74.74% for junior radiologists (p=0.0048). Procedure related Complications were observed in 34 / 380 patients (8.95%). The complication rate was less at 6.32% when performed by senior radiologists as against 16.84% for procedures done by junior radiologists (p= 0.0019). The complication rate in procedures done using co-axial technique was 8%, as against 9.1% for non-co-axial technique (p = 0.7999). The diagnostic yield using co-axial technique was 86%, as against 83.63% for non-co-axial technique (p = 0.6710). Most of the complications occurred in lesions less than 2 cm size. 11/16 cases (68.75%) in core biopsy group and 12 /18 (66.66%) in FNA group with complications were less than 2cm (p = 0.8981). Conclusions: CT guided FNA and core biopsy of chest and abdominal lesions is a reliable technique, minimally invasive and accurate with high diagnostic yield and low rate of complications in the hands of an experienced radiologist. No significant difference was noted in the yield and complications done using co-axial technique.
Authors and Affiliations
Ram Shenoy Basti, Anston Vernon Braggs, Soujanya Mynalli, Rithi Melissa D’silva, Suresh H B
Keywords
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