Kwang Taik Kim

Transthoracic fine needle aspiration and core biopsy of pulmonary lesions. A study of 296 patients.

OBJECTIVE To retrospectively investigate and compare the usefulness of transthoracic fine needle aspiration (FNA), core biopsy and a combination of the two in the diagnosis of pulmonary lesions. STUDY DESIGN Two hundred ninety-six patients who had undergone FNA, core biopsy or both for lung lesions were divided into malignant and benign groups according to the final diagnoses, which were based on the cytologic and histopathologic findings combined with clinical features. In each group, the diagnostic usefulness of FNA, core biopsy and a combination of the two were evaluated by comparing the results of each with the final diagnoses. RESULTS In the malignant group, FNA was diagnostically helpful in 188 of 205 patients (91.7%) and core biopsy in 158 of 180 patients (87.8%). The combination of the two methods improved the result to 172 of 178 patients (96.6%). The sensitivities were 94.6%, 88.3% and 97.2%, respectively, for each result. In the benign group, 71.1% (64/90), 70.1% (47/67) and 74.2% (49/66) of cases received specific or nonspecific diagnoses by FNA, core biopsy and their combination, respectively. The rates of specific diagnoses were 20.1%, 21.0% and 31.8%, respectively. CONCLUSION The combination of FNA and core biopsy markedly improved the diagnostic yields in the malignant group and, to a lesser degree, also in the benign group.

P3-052: How to evaluation of the completeness of cryotherapy in an attempt to quantify initial treatment success

How to evaluation of the completeness of cryotherapy in an attempt to quantify initial treatment success Kang, Moon Chul1 Lee, Sung Ho1 Kim, Kwang Taik1 Ham, Soo-Youn2 Cho, Sung Bum2 1 Department of Cardiothroacic Surgery, Anam Hospital, Korea University, Seoul, Korea 2 Department of Radiology, Anam Hospital, Korea University, Seoul, Korea Background: Immediate evaluation is possible for the percutaneous CT-guided cryosurgery by estimation of Hounsfield units, the size of formed ice-ball, and the percentage of tumor area covered by ice-ball. But, this method is not useful for the patient underwent fluoroscopyguided or video-assisted thoracosopic cryosurgery. And, the majority of the lesions are turned into cavitary lesion or necrotic area in the early postoperative periods. So, the aim of this study is to identify the methods and ideal time for the evaluation of the completeness of cryotherapy in an attempt to quantify initial treatment success. Methods: 52 pulmonary tumors in 34 consecutive patients (29 men and 5 women, median age 63 years, age range; 25-80 years) were treated by cryosurgery. Of the 52 pulmonary masses, 29 masses were primary lung cancers, and 23 masses were metastatic lung cancers. Cryosurgery was performed under computed tomographic, fluoroscopic or video-assisted thoracoscopic guidance. Cryoablation was performed as one or two cycles of 20-minute freeze followed by 5-minute thaw. Follow up chest CT scanning was taken at postoperative 1 month, 3 months and 6 months. We measured the area and Hounsfield units of the mass with computed tomography. And we compare the measured value respectively. Results: The measured area of the mass is ranged from 141.8mm2 to 3996.8mm2 preoperatively (postoperative 1 month; 66.8-8481.8mm2, 3 months; 32.6-4841.7mm2, 6 months; 45.6-4572.2mm2). The Hounsfield unit is ranged from 32 to 98 preoperatively (postoperative 1 month; 871, 3 months; 24-68, 6 months; 26-98). And, the decrease of the Hounsfield unit of 1 month showed good correlation of the reduction of the area of mass at postoperative 6 months (p-value=0.14). On the contrary, between the change of the Hounsfield unit and the change of the area of mass at 3 months or 6 months showed no correlation statistically. Conclusion: Postoperative computed tomographic scanning with measurement of Hounsfield unit at postoperative 1 month may be useful for the evaluation of the completeness of cryotherapy in an attempt to quantify initial treatment success.

P3-054: Safety and efficacy of percutaneous cryosurgery under the ct guidance for the treatment of lung cancer

How to evaluation of the completeness of cryotherapy in an attempt to quantify initial treatment success Kang, Moon Chul1 Lee, Sung Ho1 Kim, Kwang Taik1 Ham, Soo-Youn2 Cho, Sung Bum2 1 Department of Cardiothroacic Surgery, Anam Hospital, Korea University, Seoul, Korea 2 Department of Radiology, Anam Hospital, Korea University, Seoul, Korea Background: Immediate evaluation is possible for the percutaneous CT-guided cryosurgery by estimation of Hounsfield units, the size of formed ice-ball, and the percentage of tumor area covered by ice-ball. But, this method is not useful for the patient underwent fluoroscopyguided or video-assisted thoracosopic cryosurgery. And, the majority of the lesions are turned into cavitary lesion or necrotic area in the early postoperative periods. So, the aim of this study is to identify the methods and ideal time for the evaluation of the completeness of cryotherapy in an attempt to quantify initial treatment success. Methods: 52 pulmonary tumors in 34 consecutive patients (29 men and 5 women, median age 63 years, age range; 25-80 years) were treated by cryosurgery. Of the 52 pulmonary masses, 29 masses were primary lung cancers, and 23 masses were metastatic lung cancers. Cryosurgery was performed under computed tomographic, fluoroscopic or video-assisted thoracoscopic guidance. Cryoablation was performed as one or two cycles of 20-minute freeze followed by 5-minute thaw. Follow up chest CT scanning was taken at postoperative 1 month, 3 months and 6 months. We measured the area and Hounsfield units of the mass with computed tomography. And we compare the measured value respectively. Results: The measured area of the mass is ranged from 141.8mm2 to 3996.8mm2 preoperatively (postoperative 1 month; 66.8-8481.8mm2, 3 months; 32.6-4841.7mm2, 6 months; 45.6-4572.2mm2). The Hounsfield unit is ranged from 32 to 98 preoperatively (postoperative 1 month; 871, 3 months; 24-68, 6 months; 26-98). And, the decrease of the Hounsfield unit of 1 month showed good correlation of the reduction of the area of mass at postoperative 6 months (p-value=0.14). On the contrary, between the change of the Hounsfield unit and the change of the area of mass at 3 months or 6 months showed no correlation statistically. Conclusion: Postoperative computed tomographic scanning with measurement of Hounsfield unit at postoperative 1 month may be useful for the evaluation of the completeness of cryotherapy in an attempt to quantify initial treatment success.