Tesis

Akurasi core biopsy transtorakal dipandu gambar pindaian CT toraks di ruang operasi sebagai metode diagnostik tumor intratorakal = Accuracy of CT image-guided transthoracic core biopsy in operating theatre for intrathoracic tumors.

Latar belakang: Core biopsy transtorakal merupakan metode biopsi tumor intratorakal yang digunakan untuk mendapatkan sampel histopatologi demi menentukan penatalaksanaan. Core biopsy dipandu gambar pindaian CT toraks di ruang operasi dilakukan terutama bagi pasien yang tidak mampu berbaring, namun belum ada studi akurasi diagnostik baik di Indonesia Tujuan: Mengetahui akurasi diagnostik core biopsy transtorakal dipandu gambar pindaian CT toraks di ruang operasi untuk tumor intratorakal. Metode: Uji diagnostik dengan studi potong lintang pada semua pasien yang menjalani core biopsy transtorakal di ruang operasi di Rumah Sakit Umum Pusat Persahabatan sejak Januari 2016 – Desember 2019. Tindakan dipandu gambar pindaian CT toraks, menggunakan jarum core 18G, hasil dikelompokan menjadi ganas, jinak, dan nondiagnostik. Nilai sensitivitas, spesifisitas, akurasi, nilai duga positif, dan nilai duga negatif sebagai luaran untuk menilai akurasi diagnostik. Hasil: Penelitian melibatkan 105 subjek dengan hasil akurasi diagnostik 86,7%, sensitivitas 83,1%, spesifisitas 100%, nilai duga positif 100%, nilai duga negatif 71% dalam mendiagnosis keganasan tumor intratorakal. Komplikasi pneumotoraks 4,8%, hemotoraks 1%, tidak ada hemoptisis maupun mortalitas. Kesimpulan: Core biopsy transtorakal dipandu gambar pindaian CT toraks di ruang operasi memperlihatkan akurasi diagnostik 86,7% pada tumor intratorakal dan relatif aman
Kata kunci: Core biopsy transtorakal; tumor intratorakal; gambar pindaian CT


Background: Transthoracic needle core biopsy is one of biopsy method of intrathoracic tumors to gain histopathology sample for treatment decision. We performed CT imageguided transthoracic core biopsy in operation theatre for patient who are not able to/tolerate lie down position. Unfortunately, there are still no diagnostic accuracy study in Indonesia. Objective: to aim diagnostic accuracy of CT image-guided transthoracic needle core biopsy in operating theatre for intrathoracic tumors. Methods: All patients underwent CT image-guided transthoracic needle core biopsy since January 2016 – December 2019 are review retrospectively. Eighteen gauge automated core devices were used, and guided by CT image, core biopsy results were divide in to malignant, non-malignant, and non-diagnostic. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy are main outcome to describe diagnostic accuracies. Results: This study enrolled 105 subjects which had sensitivity of 83,1%, specificity of 100%, positive predictive value of 100%, negative predictive value of 71%, and diagnostic accuracy of 86,7% for intrathoracic malignancies. Complications of pneumothorax are 4,8% and hemothorax are 1%. No mortality was reported. Conclusion: CT image-guided transthoracic needle core biopsy in operating theatre for intrathoracic tumors had 86,7% of diagnostic accuracy, and a relatively safe procedure.
Keywords Transthoracic needle core biopsy/transthoracic core biopsy; intrathoracic tumors; CT image-guided