Comparison of the Yield of Transthoracic Needle Aspiration and Core Needle Biopsy Between Pulmonologist and Radiologist in a Community Based Practice

摘要

Background: Transthoracic needle aspiration (TTNA) and core needle biopsy (CNB) are performed by a pulmonologist or an interventional radiologist (IR) Very few pulmonary fellowship programs offer training in TTNA/CBN We compared the yield and complications of TTNA/CNB when performed by pulmonologist versus IR Method: This was a retrospective analysis of patients that underwent TTNA/CNB from 2003 to 2007 at our institution. Procedures were performed by either, any of 5 pulmonary fellows under the supervision of any of 4 pulmonologists or by a single IR,Results: Thirty-five patients were included, 19 in the pulmonary and 16 in the IR group. There were no differences in yield (P = 0,28) or complications (JP = 0,31) between the groups. The overall diagnostic yield was 6,3% for pulmonary versus 69% for IR,, Malignancy was the most common diagnosis (70%) CNB was used by pulmonary in 21 % compared with 50% of IR cases. The yield was higher when TTNA was combined with,CBN (75% vs. 61% for TTNA alone). An on-site pathologist was present only during the pulmonary cases.Conclusions: The overall yield and complications were similar in both groups. Combining TTNA and CBN provides higher yield than TTNA alone. Obtaining expertise in CNB is of the outmost importance to maximize yield and decrease need for more invasive procedures. Pulmonary fellowship programs should continue to offer training in TTNA/CNB with an onsite pathologist where available, to achieve diagnostic yield comparable with the inter ventional radiologist. Those programs should develop a system to maintain proficiency for the faculty