Feasibility, Safety, and Efficacy of the CT Guided Fine Needle Aspiration Cytology (FNAC) of Lung Lesions

Aim: We assessed the safety and accuracy of the CT Guided fine needle aspiration cytology (FNAC) of lung lesions and feasibility of the same as a day care procedure at our hospital. Methods: We performed a retrospective analysis of case records of patients with lung lesion on plain X ray who underwent CT guided FNAC. Safety was measured in terms of complication rates, efficacy in the terms of sensitivity and specificity; and feasibility in terms of the duration of post procedure hospital stay, total attempts required and the expertise needed to do the procedure. We assumed age, sex and presence of emphysema as patient related variables; size, depth of the lesion and location as the tumour related variables; and type of needle used, experience as the procedure related variables. Medcalc version 7.5 was used for the statistical analysis. Results: Age, sex, emphysema, radiologist's expertise nor the type of needle changed diagnostic yield. However location of the lesion and size had a significant influence on the diagnostic yield (Accuracy). The complication rates (Safety) were similar irrespective of the patient, tumour related and procedure related variables after adjusting for the potential confounders. It is quite feasible as the average number of attempts needed for final diagnosis is 1.13 +/- 0.26 with an average hospital stay of 1.6 +/- 0.46 requiring expert hands in less than 35% of instances (feasibility). Conclusion: FNAC can be used safely as a day care procedure at our setting. The diagnostic yield is excellent for the larger and superficial lesions, for which it can replace the trucut biopsy.