Radiological-pathological correlation of negative CT biopsy results enables high negative predictive value for...

Area of Science:

• Pulmonology
• Radiology
• Pathology
• Oncology

Background:

• Computed tomography (CT) guided lung biopsies are crucial for diagnosing lung conditions.
• Interpreting non-malignant biopsy results can be challenging, impacting diagnostic accuracy.
• Multidisciplinary team (MDT) collaboration is essential for complex case management.

Purpose of the Study:

• To evaluate the impact of multidisciplinary team (MDT) practice on radiological-pathological correlation of non-malignant lung biopsy results.
• To assess the additive effect of MDT review on the predictive values of CT biopsies for malignancy.
• To examine the influence on subsequent patient management and outcomes.

Main Methods:

• Service evaluation of MDT management for non-malignant lung biopsy results from May 2014 to May 2017.
• Analysis of 55 patients with initial non-malignant CT biopsy diagnoses.
• Classification of biopsy results as concordant or discordant with radiological findings.

Main Results:

• Of 48 potentially non-specific results, 26 were concordant and 22 discordant with radiology.
• Concordant lesions showed resolution or stability; one progressed to malignancy.
• Discordant lesions managed with repeat biopsy or resection yielded 12 benign and 9 malignant final diagnoses.
• Negative predictive value increased from 80% (CT alone) to 88% (repeat biopsy) and 97% (radiological-pathological assessment).

Conclusions:

• Combining radiological and pathological interpretation of negative biopsy results enhances the negative predictive value for lung malignancy.
• This integrated approach avoids delayed diagnosis of lung cancer.
• MDT review of non-malignant lung biopsy results improves diagnostic accuracy and patient management.