CT-Guided Transthoracic Biopsy of Lung Lesions Using a Non-Coaxial Biopsy Needle Technique: CT Characteristics Predictive for Diagnostic Accuracy and Pneumothorax
Open Access
- 30 June 2021
- journal article
- research article
- Published by Ubiquity Press, Ltd. in Journal of the Belgian Society of Radiology
- Vol. 105 (1)
- https://doi.org/10.5334/jbsr.2429
Abstract
Objectives: To analyze computed tomography (CT) characteristics predictive for diagnostic accuracy and pneumothorax in CT fluoroscopy-guided transthoracic biopsy (CTF-TTB) of lung lesions using non-coaxial biopsy needle technique. Methods: Retrospectively 274 lung lesion biopsies with confirmed histology were included in our study. CTF-TTB was done using an 18-gauge non-coaxial cutting needle. Diagnostic accuracy rates were calculated per lesion size and CT and procedural characteristics were evaluated for their predictive value regarding diagnostic accuracy and development of pneumothorax (maximal nodule diameter, distance to pleura, location per lung segment, nodule composition, benign versus malignant histology, and number of specimens). Results: Overall diagnostic accuracy of CTF-TTB was high (93%). Diagnostic accuracy for lesions <= 10 mm was 81%. Maximal nodule diameter was the only predictive CT characteristic for diagnostic success (p = 0.03). Pneumothorax occurred in 27%. Distance of lesion to pleura was the only risk factor for pneumothorax (p < 0.00001). Pneumothorax rates were significantly lower in subpleural lesions (14%) compared to those located 1-10 mm (47%), 10-20 mm (33%), and >20 mm from pleura (29%). Conclusions: High diagnostic accuracy rates were achieved with CTF-TTB using non-coaxial biopsy technique, even for lesions <= 10 mm. Pneumothorax rates were comparable with other studies. Lesion size was the only predictive CT characteristic for diagnostic accuracy. Distance to pleura was the only risk factor for pneumothorax.Keywords
This publication has 13 references indexed in Scilit:
- Computed Tomography Characteristics Predictive for Radial EBUS-Miniprobe-Guided Diagnosis of Pulmonary LesionsJournal of Thoracic Oncology, 2015
- Update in the Evaluation of the Solitary Pulmonary NoduleRadioGraphics, 2014
- Percutaneous CT-Guided Aspiration and Core Biopsy of Pulmonary Nodules Smaller Than 1 cm: Analysis of Outcomes of 305 Procedures From a Tertiary Referral CenterAmerican Journal of Roentgenology, 2013
- CT-guided transthoracic cutting needle biopsy of intrathoracic lesions: Comparison between coaxial and single needle techniqueEuropean Journal of Radiology, 2012
- CT Fluoroscopy-Guided Biopsy of 1,000 Pulmonary Lesions Performed With 20-Gauge Coaxial Cutting NeedlesSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2009
- Computed Tomography–Navigated Transthoracic Core Biopsy of Pulmonary Lesions: Which Factors Affect Diagnostic Yield and Complication Rates?Academic Radiology, 2008
- Factors influencing accuracy of CT-guided percutaneous biopsies of pulmonary lesionsEuropean Radiology, 2004
- Usefulness of New Automated Cutting Needle for Tissue-Core Biopsy of Lung Nodules Under CT Fluoroscopic GuidanceSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2003
- Factors Affecting Diagnostic Accuracy of CTguided Coaxial Cutting Needle Lung Biopsy: Retrospective Analysis of 631 ProceduresJournal of Vascular and Interventional Radiology, 2003
- Diagnostic Accuracy of CT-Guided Automated Needle Biopsy of Lung NodulesAmerican Journal of Roentgenology, 2000