Le "gold standard" et l'optimalisation du choix diagnostique: Le nodule pulmonaire et la ponction-biopsie pulmonaire transthoracique

In this review of the literature, it is emphasized that the published results about the transthoracic pulmonary needle biopsy (TPNB) cannot be readily evaluated due to the inconsistency of the reference tests, the methods and the investigated subjects. Gold-standards for evaluation of lung tumors have been described and are recalled. The limits of the TPNB are pointed out in the diagnosis of solitary pulmonary nodules and benign lesions. In a bayesian approach, it is shown that the TPNB is only useful in confirming an a-priori diagnosis of cancer.