Diagnostic value of ultrasound guided transthoracic tru-cut biopsy in thorax malignancies

Aim: To investigate the diagnostic value of ultrasound (US) guided transthoracic fine needle aspiration biopsy (TTFNA) and US guided transthoracic tru-cut biopsy (TTTCB) in malignant thorax lesions.
Material and method: Patients who underwent US guided transthoracic biopsies between April 2014 and May 2017 were retrospectively evaluated. Patients who were diagnosed as thoracic malignancy and both TTTCB and TTFNA performed for the same lesion were included in the study. The diagnostic accuracy of TTTCB, TTFNA and their combination were analyzed. The diagnostic accurracy of methods were ststistically compared by McNemar Test.
Results: Thirty two patients were included in the study. Ultrasound guided TTFNA and/or TTTCB were diagnostic in 30 (93.8%) of them. TTFNA was diagnostic in 23 (%71.8), TTTCB were diagnostic in 26 (%81.2) of these pateints. Seven (77.7%) of 9 patients in which TTFNA was not diagnostic, TTTCB was diagnostic. The diagnostic accuracy was 71.8% and 81.2% for TTFNA and TTTCB, respectively. When TTTCB and TTFNA were performed consecutively in the same procedure, the overall diagnostic accuracy was 93.7%. There was no difference between the diagnostic accuracy of US-guided TTFNA and TTTCB (p=0.508). The diagnostic accuracy of combination of TTFNA and TTTCB was significantly higher than that of TTFNA alone (p=0.016). During the procedures, pneumothorax which didnot require chest tube insertion was detected as complication in 1 case (3.1%).
Conclusion: Diagnostic accuracy of US-guided TTFNA and TTTCB is high and has no superiority to each other. Combining both procedures under the quidence of US increases the diagnostic accuracy statistically significantly.