Malignant pleural mesothelioma: US-guided histologic core-needle biopsy

Our plain-English summary of Malignant pleural mesothelioma: US-guided histologic core-needle biopsy, by A. Heilo, A.E. Stenwig, O.P. Solheim (Radiology, 1999).

The study

• Authors: A. Heilo, A.E. Stenwig, O.P. Solheim
• Journal: Radiology
• Published: 1999;211(3):657-9
• Cited by: 63 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Purpose: To assess the clinical use of ultrasonographically (US) guided core-needle biopsy, performed with a one-hand automatic sampling technique, in the diagnosis of malignant pleural mesothelioma (MPM).

Materials And Methods: The authors reviewed the findings in 70 patients with a tentative diagnosis of MPM who underwent US-guided core-needle biopsy at our institution during the past 10 years.

Results: Fifty-two of the 70 patients who underwent automatic high-speed core-needle biopsy at our institution had MPM; 18 had other disorders. The correct diagnosis was made in 56 patients. Twelve of 14 inadequate biopsy specimens were false-negative for MPM. There were no false-positive biopsy results. In the detection of MPM, US-guided core-needle biopsy had a sensitivity of 77%, specificity of 88%, accuracy of 80%, positive predictive value of 100%, and negative predictive value of 57%. There were no serious complications.

Conclusion: US-guided core-needle biopsy is highly effective in the diagnosis of MPM. Owing to its simplicity, low cost, and few side effects, it could be the biopsy method of choice for detection of this condition.

In plain English

This retrospective study reviewed 70 patients (63 men, seven women) with a suspected diagnosis of malignant pleural mesothelioma. All had ultrasound-guided core-needle biopsies of the pleura at the Norwegian Radium Hospital in Oslo over a 10-year period. The article does not report the patients' asbestos exposure. Of the 70 patients, 52 had mesothelioma and 18 had other disorders. At the first biopsy attempt, mesothelioma was diagnosed in 40 patients, a sensitivity of 77%. Other diseases were correctly diagnosed in 16 patients, a specificity of 88%. Overall accuracy was 80% (56 of 70 patients), and no biopsy wrongly indicated mesothelioma. In 14 patients the tissue sample was inadequate, and 12 of them had mesothelioma. The authors found no significant difference in accuracy between the needle types used. There were two minor complications and no serious ones. No tumor spread to the skin at needle entry sites was observed. The authors concluded that the method is highly effective and could become the biopsy method of choice. They also noted that surgical and thoracoscopic biopsies seem to be more accurate.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective review of diagnostic biopsy results (diagnostic accuracy study)
• Who was studied: 70 patients (seven women, 63 men; aged 19 to 80, mean 65) with a tentative diagnosis of malignant pleural mesothelioma, admitted to the Norwegian Radium Hospital, Oslo, over the past 10 years; 82 biopsy procedures in total
• Exposure: Not reported. The study evaluated a biopsy method (ultrasound-guided core-needle biopsy), not asbestos exposure.
• Main results:
  • Of the 70 patients, 52 had malignant pleural mesothelioma and 18 had other disorders
  • For detecting mesothelioma, first-attempt biopsy had sensitivity 77%, specificity 88%, accuracy 80% (56 of 70 patients), positive predictive value 100% (40 of 40) and negative predictive value 57% (16 of 28)
  • In 14 patients the biopsy specimen was inadequate; 12 of these had mesothelioma (false-negative). There were no false-positive results.
  • Among patients with mesothelioma, first-attempt biopsy of lesions in the costophrenic region was done 21 times and gave the diagnosis 17 times
  • No significant difference in diagnostic accuracy was found between the different needle-gun combinations
  • There were no serious complications. Two minor complications occurred, including slight coughing up of blood that needed no treatment.
  • No skin metastases were observed at the biopsy needle entry site; two cases of skin metastases after pleural fluid drainage were reported in patients' records
• The authors' conclusion: The authors concluded that ultrasound-guided core-needle biopsy is highly effective in diagnosing malignant pleural mesothelioma and, owing to simplicity, low cost and few side effects, could be the biopsy method of choice
• Limitations the authors state:
  • The authors stated that surgical and thoracoscopic biopsies seem to have higher accuracy than ultrasound-guided biopsy
  • Ultrasound can only guide biopsy of pleural areas not hidden behind bone or aerated lung tissue

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Needle Biopsy, Biopsy.

Related studies

• CT-guided core-needle biopsy in omental pathology — F. Pombo, E. Rodriguez, et al. (1997)
• Advantages of thoracic ultrasound-guided fine-needle aspiration biopsy in lung cancer and mesothelioma — M. Sperandeo, L. Dimitri, et al. (2014)
• Physician-based ultrasound-guided biopsy for diagnosing pleural disease — R.J. Hallifax, J.P. Corcoran, et al. (2014)
• Percutaneous image-guided cutting needle biopsy of the pleura in the diagnosis of malignant mesothelioma — R.F. Adams, W. Gray, et al. (2001)
• Medical thoracoscopy vs CT scan-guided Abrams pleural needle biopsy for diagnosis of patients with pleural effusions: a randomized, controlled trial — M. Metintas, G. Ak, et al. (2010)
• The role of endobronchial ultrasound guided transbronchial needle aspiration cytology in the investigation of mediastinal lymphadenopathy and masses, the North Tees experience — S. Natu, J. Hoffman, et al. (2010)

Browse more research in Radiology, or return to medical research.