CT-guided pretreatment biopsy diagnosis in patients with thymic epithelial tumours: diagnostic accuracy and risk of seeding
To investigate the diagnostic performance of computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) for thymic epithelial tumours (TETs) and the complication rate after PTNB including seeding after PTNB. This retrospective study identified PTNBs for anterior mediastinal lesi...
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| Veröffentlicht in: | Clinical radiology 2024-04, Vol.79 (4), p.263-271 |
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| creator | Ahn, Y. Lee, S.M. Choi, S. Choe, J. Oh, S.Y. Do, K.-H. Seo, J.B. |
| description | To investigate the diagnostic performance of computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) for thymic epithelial tumours (TETs) and the complication rate after PTNB including seeding after PTNB.
This retrospective study identified PTNBs for anterior mediastinal lesions between May 2007 and September 2021. The diagnostic performance for TETs and complications were investigated. The concordance of the histological grades of TETs between PTNB and surgery was evaluated. The factors associated with pleural seeding after PTNB were determined using Cox regression analysis.
Of 387 PTNBs, 235 PTNBs from 225 patients diagnosed as TETs (124 thymomas and 101 thymic carcinomas) and 150 PTNBs from 133 patients diagnosed as other than TETs were included. The sensitivity, specificity, and accuracy for TETs were 89.4% (210/235), 100% (210/210), and 93.5% (360/385), respectively, with an immediate complication rate of 4.4% (17/385). The concordance rate of the histological grades between PTNB and surgery was 73.3% (77/105) after excluding uncategorised types of thymomas. During follow-up after PTNB (median duration, 38.8 months; range, 0.3–164.6 months), no tract seeding was observed. Pleural seeding was observed in 26 patients. Thymic carcinoma (hazard ratio [HR], 5.94; 95% confidence interval [CI], 2.07–17.08; p=0.001) and incomplete resection (HR, 3.29; 95% CI, 1.20–9.02; p=0.02) were associated with pleural seeding, while the biopsy approach type (transpleural versus parasternal) was not associated (p=0.12).
Pretreatment biopsy for TETs was accurate and safe and may be considered for diagnosing TETs, particularly when the diagnosis is challenging and histological diagnosis is mandatory.
•Pretreatment biopsy for TETs was accurate, with a sensitivity of 89.4% (210/235).•No tract seeding was observed in TETs during follow-up.•The transpleural approach was not associated with pleural seeding after biopsy. |
| doi_str_mv | 10.1016/j.crad.2023.12.009 |
| format | Article |
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This retrospective study identified PTNBs for anterior mediastinal lesions between May 2007 and September 2021. The diagnostic performance for TETs and complications were investigated. The concordance of the histological grades of TETs between PTNB and surgery was evaluated. The factors associated with pleural seeding after PTNB were determined using Cox regression analysis.
Of 387 PTNBs, 235 PTNBs from 225 patients diagnosed as TETs (124 thymomas and 101 thymic carcinomas) and 150 PTNBs from 133 patients diagnosed as other than TETs were included. The sensitivity, specificity, and accuracy for TETs were 89.4% (210/235), 100% (210/210), and 93.5% (360/385), respectively, with an immediate complication rate of 4.4% (17/385). The concordance rate of the histological grades between PTNB and surgery was 73.3% (77/105) after excluding uncategorised types of thymomas. During follow-up after PTNB (median duration, 38.8 months; range, 0.3–164.6 months), no tract seeding was observed. Pleural seeding was observed in 26 patients. Thymic carcinoma (hazard ratio [HR], 5.94; 95% confidence interval [CI], 2.07–17.08; p=0.001) and incomplete resection (HR, 3.29; 95% CI, 1.20–9.02; p=0.02) were associated with pleural seeding, while the biopsy approach type (transpleural versus parasternal) was not associated (p=0.12).
Pretreatment biopsy for TETs was accurate and safe and may be considered for diagnosing TETs, particularly when the diagnosis is challenging and histological diagnosis is mandatory.
•Pretreatment biopsy for TETs was accurate, with a sensitivity of 89.4% (210/235).•No tract seeding was observed in TETs during follow-up.•The transpleural approach was not associated with pleural seeding after biopsy.</description><identifier>ISSN: 0009-9260</identifier><identifier>ISSN: 1365-229X</identifier><identifier>EISSN: 1365-229X</identifier><identifier>DOI: 10.1016/j.crad.2023.12.009</identifier><identifier>PMID: 38220515</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Biopsy, Needle - methods ; Humans ; Image-Guided Biopsy - adverse effects ; Image-Guided Biopsy - methods ; Neoplasms, Glandular and Epithelial - diagnostic imaging ; Retrospective Studies ; Thymoma - diagnostic imaging ; Thymus Neoplasms - diagnostic imaging ; Tomography, X-Ray Computed - methods</subject><ispartof>Clinical radiology, 2024-04, Vol.79 (4), p.263-271</ispartof><rights>2024 The Royal College of Radiologists</rights><rights>Copyright © 2024 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c307t-f0a6a711a6bac7051bdd85afea9317e1e80d7674f854ffb62049b9305fe7337e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0009926024000023$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38220515$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ahn, Y.</creatorcontrib><creatorcontrib>Lee, S.M.</creatorcontrib><creatorcontrib>Choi, S.</creatorcontrib><creatorcontrib>Choe, J.</creatorcontrib><creatorcontrib>Oh, S.Y.</creatorcontrib><creatorcontrib>Do, K.-H.</creatorcontrib><creatorcontrib>Seo, J.B.</creatorcontrib><title>CT-guided pretreatment biopsy diagnosis in patients with thymic epithelial tumours: diagnostic accuracy and risk of seeding</title><title>Clinical radiology</title><addtitle>Clin Radiol</addtitle><description>To investigate the diagnostic performance of computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) for thymic epithelial tumours (TETs) and the complication rate after PTNB including seeding after PTNB.
This retrospective study identified PTNBs for anterior mediastinal lesions between May 2007 and September 2021. The diagnostic performance for TETs and complications were investigated. The concordance of the histological grades of TETs between PTNB and surgery was evaluated. The factors associated with pleural seeding after PTNB were determined using Cox regression analysis.
Of 387 PTNBs, 235 PTNBs from 225 patients diagnosed as TETs (124 thymomas and 101 thymic carcinomas) and 150 PTNBs from 133 patients diagnosed as other than TETs were included. The sensitivity, specificity, and accuracy for TETs were 89.4% (210/235), 100% (210/210), and 93.5% (360/385), respectively, with an immediate complication rate of 4.4% (17/385). The concordance rate of the histological grades between PTNB and surgery was 73.3% (77/105) after excluding uncategorised types of thymomas. During follow-up after PTNB (median duration, 38.8 months; range, 0.3–164.6 months), no tract seeding was observed. Pleural seeding was observed in 26 patients. Thymic carcinoma (hazard ratio [HR], 5.94; 95% confidence interval [CI], 2.07–17.08; p=0.001) and incomplete resection (HR, 3.29; 95% CI, 1.20–9.02; p=0.02) were associated with pleural seeding, while the biopsy approach type (transpleural versus parasternal) was not associated (p=0.12).
Pretreatment biopsy for TETs was accurate and safe and may be considered for diagnosing TETs, particularly when the diagnosis is challenging and histological diagnosis is mandatory.
•Pretreatment biopsy for TETs was accurate, with a sensitivity of 89.4% (210/235).•No tract seeding was observed in TETs during follow-up.•The transpleural approach was not associated with pleural seeding after biopsy.</description><subject>Biopsy, Needle - methods</subject><subject>Humans</subject><subject>Image-Guided Biopsy - adverse effects</subject><subject>Image-Guided Biopsy - methods</subject><subject>Neoplasms, Glandular and Epithelial - diagnostic imaging</subject><subject>Retrospective Studies</subject><subject>Thymoma - diagnostic imaging</subject><subject>Thymus Neoplasms - diagnostic imaging</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>0009-9260</issn><issn>1365-229X</issn><issn>1365-229X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1r3DAQhkVoSLZp_0APQcde7OrDstchl7IkbSGQSwq5ibE02mjrr0hyy9I_Hy2b9NjTMDPv-zLzEPKJs5IzXn_ZlSaALQUTsuSiZKw9ISsua1UI0T6-IyuWR0UranZO3se4O7SVqM7IuVwLwRRXK_J381BsF2_R0jlgCghpwDHRzk9z3FPrYTtO0UfqRzpD8nkX6R-fnmh62g_eUJxzg72HnqZlmJYQr95cKa_BmCWA2VMYLQ0-_qKToxHR-nH7gZw66CN-fK0X5OftzcPme3F3_-3H5utdYSRrUuEY1NBwDnUHpslnd9auFTiEVvIGOa6ZbeqmcmtVOdfVglVt10qmHDZSNigvyOdj7hym5wVj0oOPBvseRpyWqEXLK6FErVSWiqPUhCnGgE7PwQ8Q9pozfYCud_oAXR-gay50RppNl6_5Szeg_Wd5o5wF10cB5i9_eww6mkzSZAoBTdJ28v_LfwFOd5WI</recordid><startdate>202404</startdate><enddate>202404</enddate><creator>Ahn, Y.</creator><creator>Lee, S.M.</creator><creator>Choi, S.</creator><creator>Choe, J.</creator><creator>Oh, S.Y.</creator><creator>Do, K.-H.</creator><creator>Seo, J.B.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202404</creationdate><title>CT-guided pretreatment biopsy diagnosis in patients with thymic epithelial tumours: diagnostic accuracy and risk of seeding</title><author>Ahn, Y. ; Lee, S.M. ; Choi, S. ; Choe, J. ; Oh, S.Y. ; Do, K.-H. ; Seo, J.B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-f0a6a711a6bac7051bdd85afea9317e1e80d7674f854ffb62049b9305fe7337e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Biopsy, Needle - methods</topic><topic>Humans</topic><topic>Image-Guided Biopsy - adverse effects</topic><topic>Image-Guided Biopsy - methods</topic><topic>Neoplasms, Glandular and Epithelial - diagnostic imaging</topic><topic>Retrospective Studies</topic><topic>Thymoma - diagnostic imaging</topic><topic>Thymus Neoplasms - diagnostic imaging</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ahn, Y.</creatorcontrib><creatorcontrib>Lee, S.M.</creatorcontrib><creatorcontrib>Choi, S.</creatorcontrib><creatorcontrib>Choe, J.</creatorcontrib><creatorcontrib>Oh, S.Y.</creatorcontrib><creatorcontrib>Do, K.-H.</creatorcontrib><creatorcontrib>Seo, J.B.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ahn, Y.</au><au>Lee, S.M.</au><au>Choi, S.</au><au>Choe, J.</au><au>Oh, S.Y.</au><au>Do, K.-H.</au><au>Seo, J.B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>CT-guided pretreatment biopsy diagnosis in patients with thymic epithelial tumours: diagnostic accuracy and risk of seeding</atitle><jtitle>Clinical radiology</jtitle><addtitle>Clin Radiol</addtitle><date>2024-04</date><risdate>2024</risdate><volume>79</volume><issue>4</issue><spage>263</spage><epage>271</epage><pages>263-271</pages><issn>0009-9260</issn><issn>1365-229X</issn><eissn>1365-229X</eissn><abstract>To investigate the diagnostic performance of computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) for thymic epithelial tumours (TETs) and the complication rate after PTNB including seeding after PTNB.
This retrospective study identified PTNBs for anterior mediastinal lesions between May 2007 and September 2021. The diagnostic performance for TETs and complications were investigated. The concordance of the histological grades of TETs between PTNB and surgery was evaluated. The factors associated with pleural seeding after PTNB were determined using Cox regression analysis.
Of 387 PTNBs, 235 PTNBs from 225 patients diagnosed as TETs (124 thymomas and 101 thymic carcinomas) and 150 PTNBs from 133 patients diagnosed as other than TETs were included. The sensitivity, specificity, and accuracy for TETs were 89.4% (210/235), 100% (210/210), and 93.5% (360/385), respectively, with an immediate complication rate of 4.4% (17/385). The concordance rate of the histological grades between PTNB and surgery was 73.3% (77/105) after excluding uncategorised types of thymomas. During follow-up after PTNB (median duration, 38.8 months; range, 0.3–164.6 months), no tract seeding was observed. Pleural seeding was observed in 26 patients. Thymic carcinoma (hazard ratio [HR], 5.94; 95% confidence interval [CI], 2.07–17.08; p=0.001) and incomplete resection (HR, 3.29; 95% CI, 1.20–9.02; p=0.02) were associated with pleural seeding, while the biopsy approach type (transpleural versus parasternal) was not associated (p=0.12).
Pretreatment biopsy for TETs was accurate and safe and may be considered for diagnosing TETs, particularly when the diagnosis is challenging and histological diagnosis is mandatory.
•Pretreatment biopsy for TETs was accurate, with a sensitivity of 89.4% (210/235).•No tract seeding was observed in TETs during follow-up.•The transpleural approach was not associated with pleural seeding after biopsy.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>38220515</pmid><doi>10.1016/j.crad.2023.12.009</doi><tpages>9</tpages></addata></record> |
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| ispartof | Clinical radiology, 2024-04, Vol.79 (4), p.263-271 |
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| subjects | Biopsy, Needle - methods Humans Image-Guided Biopsy - adverse effects Image-Guided Biopsy - methods Neoplasms, Glandular and Epithelial - diagnostic imaging Retrospective Studies Thymoma - diagnostic imaging Thymus Neoplasms - diagnostic imaging Tomography, X-Ray Computed - methods |
| title | CT-guided pretreatment biopsy diagnosis in patients with thymic epithelial tumours: diagnostic accuracy and risk of seeding |
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