Transthoracic Fine-Needle Aspiration Guided by Fluoroscopy: Validity and Complications with 19 Operators

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Abstract
During a 3-year period, 19 physicians performed 271 transthoracic fine-needle aspirations (FNA) in 199 patients, using a 23-gauge aspiration needle with an 18-gauge guiding needle. The diagnosis was confirmed by cytological examination of the needle aspirates in 90 out of 122 patients with malignant tumors, giving a sensitivity of 74%. The specificity of the cytological diagnosis was 100%. Both cytological and histological material was available in 49 patients. The tumor typing from the FNA specimens and the biopsies was in agreement in all but 3 cases. Pneumothorax occurred in 27% of the patients, but only 3.5% required tube drainage. Small variations (p > 0.05) in number of diagnostic punctures and rate of complications were evident among the participating physicians and between two fluoroscopic equipments.