ObjectiveTo systematically review the diagnostic accuracy of C-arm cone-beam CT (CBCT)-guided percutaneous transthoracic needle biopsy (PTNB) for lung nodules. MethodsWe electronically searched databases including PubMed, EMbase, EBSCO, Ovid, CBM, VIP, WanFang Data and CNKI from inception to Feb 28th, 2015, to collect diagnostic studies of CBCT-guided PTNB for lung nodules. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies by QUADAS-1 tool. Then, meta-analysis was performed by Stata 12.0 and Meta-DiSc 1.4 softwares for calculating pooled sensitivity (Sen), specificity (Spe), positive likelihood ration (+LR), negative likelihood ration (-LR), and diagnostic odds ratio (DOR), drawing summary receiver operating characteristic (SROC) curve and estimating area under the curve (AUC). ResultsA total of 9 studies involving 1 815 patients were included. The results of meta-analysis showed that the pooled Sen, Spe, +LR,-LR, and DOR were 0.95 (95%CI 0.92 to 0.96), 1.00 (95%CI 0.66 to 1.00), 2 076.58 (95%CI 1.8 to 2.3e+0.6), 0.05 (95%CI 0.04 to 0.08), and 39 443.88 (95%CI 30.53 to 5.1e+0.7), respectively. The AUC of SROC was 0.97 (95%CI 0.95 to 0.98). ConclusionCBCT-guided PTNB can be used as one of the primary examination approaches for lung nodules with relatively high diagnostic accuracy. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo evaluate the diagnostic value of computer tomography (CT)-guided percutaneous lung biopsy and tissue culture in pulmonary diseases. MethodsAfter the preoperative evaluation, 48 patients underwent CT-guided percutaneous lung biopsy were analyzed, and 16 patients accepted tissue culture. The clinical significance of combined diagnostic rate of histopathology and tissue culture was investigated. ResultsAll patients were punctured successfully. The pathological diagnosis confirmed 26 (54.2%) cases with malignant lesions and 16 (33.3%) cases with benign lesions. Six cases could not be pathological diagnosed. The pathological diagnostic rate was 87.5%. Sixteen patients accepted tissue culture. Among them 3 cases with benign lesions were cultured. The positive rate of tissue culture was 18.8%, and improved to 30.0% in the patients with benign lesion. The combined diagnostic rate of histopathology and tissue culture was 89.6%. In addition, the accuracy rate of pathological diagnosis in the group of lung nodules was 95.0%, higher than the others. The accuracy rate of pathological diagnosis in lung nodules of 2cm~3cm in diameter was 100.0%, and the positive rate of tissue culture in lung lump of 3cm~5cm in diameter was 25.0%. The incidence of pneumothorax and hemorrhage was 14.6%. ConclusionsCT-guided percutaneous lung biopsy is a safe and effective diagnostic method. For pulmonary infectious diseases, combination of CT-guided percutaneous lung biopsy and tissue culture can improve the early diagnostic rate.