Diagnostic value of ultrasound guided transthoracic core needle biopsy in mediastinal lesions

The aim: of the study is to evaluate the diagnostic value and the complication rate of ultrasound guided transthoracic core needle biopsy (US-TCNB), including large bore (14G) cutting biopsy, in patients with mediastinal lesions. Patients and Methods: This prospective study was conducted between March 2004 and June 2010. Including criteria: 1. Patients with mediastinal lesions detected on thoracic CT scan; 2. Dimension of the lesions more than 15 mm; 3. Without histological diagnosis after bronchoscopic biopsy; 4. Normal coagulation status; 5. Written informed consent. Contraindication: 1. Uncorrectable abnormalities in coagulation. Results: A total of 509 patients with mediastinal lesions suspicious of malignancy were evaluated. US visualization of the mediastinal lesions was successful in 57.4%. In all of them US-TCNB was performed. The US guided TCNB was a highly effective (accuracy 96%, Se 96%) and safe tool in diagnosis of all subgroups mediastinal lesions. In accuracy, it competed with the surgical biopsy techniques (98.5%) and CT-TCNB (90%), but was less invasive and with lower complication rate (2.4%). Conclusion: In our institution US-TCNB of mediastinal lesions is evidently a highly effective and safe tool, the method of choice in critically ill patients.