Factors that contribute to false-negative results in CT-guided transthoracic lung core-needle biopsy

To investigate the possibility of false-negative occurrence of non-specific benign pathological results on CT-guided transthoracic lung core-needle biopsy and identify risk factors for false-negative results. The clinical, imaging, and surgical data of 403 lung biopsy patients were retrospectively analyzed. Patients were divided into true-negative and false-negative (FN) groups according to the final diagnosis. Univariate analysis was used to compare the variables in two groups for statistical differences, and multivariate analysis was used to clarify the risk factors associated with FN results. Of the 403 lesions, 332 were finally confirmed as benign and 71 to be malignant, with a FN rate of 17.6%. Older patient age (P = 0.01), burr sign (P = 0.00), and pleural traction sign (P = 0.02) were independent risk factors for FN results. The area under the receiver operating characteristic (ROC) curve's area under curve (AUC) was 0.73. CT-guided transthoracic lung core-needle biopsy has a high diagnostic accuracy and low rate of FN results. Older patient age, the burr sign, and the pleural traction sign are independent risk factors for FN results that should be monitored prior to surgery to reduce the risk of FN results.