The diagnostic value of CT-guided percutaneous puncture biopsy of pulmonary ground-glass nodules: a meta-analysis

BACKGROUND: More and more pulmonary ground-glass nodules (GGNs) are screened with the extensive usage of low-dose computed tomography (CT). The need of CT-guided percutaneous puncture biopsy of GGN remains controversial. PURPOSE: To explore the diagnostic accuracy of CT-guided percutaneous puncture biopsy of GGNs. MATERIAL AND METHODS: We searched PubMed, EMBASE, the Cochrane Library, and CNKI. Included studies reported the puncture biopsy results of pulmonary GGNs, including the number of true positive (TP), false positive (FP), true negative (TN), and false negative (FN) cases. After evaluating the studies, statistical analysis, and quality assessment, the pooled diagnostic sensitivity (SEN), specificity (SPE), and diagnostic odds ratio (DOR) were calculated. The summary receiver operating characteristic (SROC) curve was constructed and the area under the curve (AUC) was calculated. Subgroup analysis was performed according to whether spiral CT or fluoroscopy-guided CT was used in the study. RESULTS: This meta-analysis included 14 studies with a total of 759 patients (702 samples). The pooled SEN, SPE, and DOR of CT-guided puncture biopsy of pulmonary GGNs were 0.91 (95% confidence interval [CI] = 0.89-0.94), 0.99 (95% CI = 0.95-1.00), and 138.72 (95% CI = 57.98-331.89), respectively. The AUC was 0.97. CONCLUSION: Our results indicated that CT-guided puncture biopsy of GGNs has high SEN, SPE, and DOR, which proved that CT-guided puncture biopsy was a good way to determine the pathological nature of GGN.