Results of CT-guided transthoracic biopsy in the diagnosis of anterior mediastinal tumors
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Abstract
Objective: To evaluate the diagnostic value and safety of computed tomography (CT)-guided percutaneous transthoracic biopsy in the diagnosis of anterior mediastinal masses.
Materials and Methods: A cross-sectional descriptive study with analysis was conducted on 21 biopsy procedures in 20 patients with anterior mediastinal lesions who underwent CT-guided percutaneous transthoracic biopsy at Hanoi Medical University Hospital from August 2023 to February 2026. Clinical characteristics, CT imaging findings, biopsy technical features, histopathological results, and procedure-related complications were collected and analyzed. Biopsy results were compared with the final diagnosis based on surgical pathology or at least 3 months of clinical and imaging follow-up.
Results: The study included 21 biopsy procedures in 20 patients, with a mean age of 54.15 ± 20.33 years. Most lesions were located in the anterior mediastinum (85%) and measured 5–10 cm in size (70%). The parasternal approach was predominantly used (90%), with a mean needle pathway length of 3.1 cm. The technical success rate was 100%.
The overall diagnostic yield was 86%, including a specific histopathological diagnosis in 75% of cases. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 90%, 100%, 100%, 33.3%, and 86%, respectively. Thymoma was the most common pathological subtype, with a histological diagnostic sensitivity of 86%.
The overall complication rate was 14%, including pneumothorax, pneumomediastinum, mediastinal hemorrhage and pulmonary hemorrhage. All complications were minor (Grade A according to the Society of Interventional Radiology classification) and required no therapeutic intervention.
Conclusion: CT-guided percutaneous transthoracic biopsy is a minimally invasive, safe, and effective technique for the diagnosis of anterior mediastinal masses. The procedure demonstrates a high technical success rate, good diagnostic accuracy for malignant lesions, and a low complication rate, thereby reducing the need for invasive diagnostic surgery.
Keywords
anterior mediastinal mass, percutaneous transthoracic biopsy, computed tomography, Thymoma.
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