{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:12:23Z","timestamp":1788667943429,"version":"build-2803163510"},"reference-count":21,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the diagnostic efficacy of computed tomography\u2013guided percutaneous biopsy combined with metagenomic next-generation sequencing in patients with blood culture-negative systemic infections and to assess the clinical impact of using this combined strategy for etiological confirmation and guidance of targeted antimicrobial therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective observational cohort study enrolled 78 patients who met the Sepsis-3 consensus criteria for suspected systemic infection and had negative conventional microbiological work-ups (at least two sets of blood cultures) between April 2022 and March 2025. All patients underwent computed tomography\u2013guided biopsy of radiologically identified infectious foci, with specimens processed concurrently for conventional culture and metagenomic next-generation sequencing. Diagnostic performance was benchmarked against the final comprehensive clinical diagnosis, and the influence of metagenomic next-generation sequencing findings on antimicrobial therapy modification was analyzed. Sample size calculation, based on a prior study estimating an metagenomic next-generation sequencing detection rate of 85% (\u03b1\u2009=\u20090.05, \u03b2\u2009=\u20090.2), indicated a minimum of 68 cases; accordingly, 78 patients were enrolled.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Computed tomography\u2013guided biopsy was technically successful in all 78 patients (100%). The pathogen detection rate of metagenomic next-generation sequencing (91.0%, 71\/78) was significantly higher than that of conventional culture (55.1%, 43\/78;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Using the final clinical diagnosis as the reference standard, metagenomic next-generation sequencing achieved a sensitivity of 94.7% (95% confidence interval: 86.9\u201398.5), specificity of 100.0% (95% confidence interval: 29.2\u2013100.0), positive predictive value of 100.0% (95% confidence interval: 94.9\u2013100.0), and negative predictive value of 42.9% (95% confidence interval: 9.9\u201381.6). Among the 35 culture-negative specimens, metagenomic next-generation sequencing established a definitive microbiological diagnosis in 28 cases (80.0%) and detected polymicrobial infections in 11 cases (14.1% of the cohort). Antimicrobial therapy was rationally adjusted based on metagenomic next-generation sequencing results in 69.2% (54\/78) of the patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The integration of computed tomography\u2013guided precision biopsy with metagenomic next-generation sequencing offers a highly effective diagnostic approach for blood culture-negative systemic infections. This synergistic strategy improves etiological diagnosis by providing high-yield target specimens that enable comprehensive, unbiased pathogen screening, facilitates differentiation between infectious and non-infectious etiologies, and supplies critical evidence for guiding precision antimicrobial therapy. These findings highlight the growing role of interventional radiology in the contemporary framework of precision infectious disease management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261481695","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:50:53Z","timestamp":1788537053000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Computed tomography\u2013guided precision biopsy combined with metagenomic next-generation sequencing for etiological diagnosis in patients with blood culture-negative systemic infections"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2658-8569","authenticated-orcid":false,"given":"Yongkun","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Radiology, Sichuan Provincial Corps Hospital, Chinese People's Armed Police Force, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenglin","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sichuan Provincial Corps Hospital, Chinese People's Armed Police Force, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pingping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sichuan Provincial Corps Hospital, Chinese People's Armed Police Force, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengping","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sichuan Provincial Corps Hospital, Chinese People's Armed Police Force, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sichuan Provincial Corps Hospital, Chinese People's Armed Police Force, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000007089"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.2717"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-025-08151-1"},{"key":"e_1_3_3_6_2","first-page":"1885","article-title":"[The application value of metagenomic next-generation sequencing technology in diagnosis and treatment of pulmonary infection in immunocompromised patients]","volume":"103","author":"Duan Z","year":"2023","unstructured":"Duan Z, Shen Z, Hu J, et al. [The application value of metagenomic next-generation sequencing technology in diagnosis and treatment of pulmonary infection in immunocompromised patients]. Zhonghua Yi Xue Za Zhi 2023; 103: 1885\u20131891.","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-020-1105-z"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1803396"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy584"},{"key":"e_1_3_3_10_2","first-page":"553","article-title":"Diagnostic value of computed tomography-guided biopsy in the diagnosis of spondylodiscitis","volume":"28","author":"Akin M","year":"2022","unstructured":"Akin M, Yildirim D, Ciftci E, et al. Diagnostic value of computed tomography-guided biopsy in the diagnosis of spondylodiscitis. 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Nat Rev Genet 2019; 20: 341\u2013355.","journal-title":"Nat Rev Genet"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41564-018-0349-6"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/01616412.2023.2247299"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix881"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa035"},{"key":"e_1_3_3_16_2","first-page":"107","article-title":"Expert consensus on the application of metagenomic high-throughput sequencing technology in pathogen detection for infectious diseases","volume":"44","author":"Chinese Society of Laboratory Medicine, Chinese Medical Association","year":"2021","unstructured":"Chinese Society of Laboratory Medicine, Chinese Medical Association. Expert consensus on the application of metagenomic high-throughput sequencing technology in pathogen detection for infectious diseases. 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