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Clinical Investigations: COIN LESIONS |

Usefulness of New Automated Cutting Needle for Tissue-Core Biopsy of Lung Nodules Under CT Fluoroscopic Guidance*

Takuji Yamagami; Shigeharu Iida; Takeharu Kato; Osamu Tanaka; Shogo Toda; Daishiro Kato; Tsunehiko Nishimura
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*From the Departments of Radiology (Drs. Yamagami, Iida, T. Kato, Tanaka, and Nishimura) and General Thoracic Surgery (Drs. Toda and D. Kato), Kyoto Prefectural University of Medicine, Kyoto, Japan.

Address requests to: Takuji Yamagami, MD, PhD, Department of Radiology, Kyoto Prefectural University of Medicine, 465 Kajii, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan; e-mail: yamagami@koto.kpu-m.ac.jp



Chest. 2003;124(1):147-154. doi:10.1378/chest.124.1.147
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Objectives: The goal of our study was to evaluate the efficacy and safety of a new type of automated cutting needle for tissue-core lung biopsy under real-time CT fluoroscopic guidance.

Design: Observational

Materials and methods: One hundred ten percutaneous needle tissue-core lung biopsies were performed with the Auto Surecut needle (Create Medic; Yokohama, Japan) under CT fluoroscopic guidance, and the specimens obtained underwent histopathologic evaluation. A final diagnosis was confirmed by independent surgical pathology.

Results: The rate of success for the diagnosis for specimens that were adequate for histopathologic analysis was 94.5% (104 of 110 specimens). The sensitivity, specificity, and accuracy in diagnosing malignancy were 95.1%, 100%, and 96.2%, respectively. A specific cell type could be characterized in 95.2% of those 104 lesions (99 lesions; malignant, 76 lesions; benign, 23 lesions). The specific cell type was precisely diagnosed, and was confirmed after surgery in 65 malignant lesions and 23 benign lesions. The biopsy-induced complications encountered were pneumothorax in 34.5% (38 of 110 patients) and hemoptysis in 6.4% (7 of 110 patients). No patient had a serious complication.

Conclusion: CT fluoroscopy-guided lung biopsy using the Auto Surecut needle provides a high degree of diagnostic accuracy, allows for the specific characterization of lung nodules, and can be performed safely.

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