A novel technique for CT-guided transthoracic biopsy of lung lesions: improved biopsy accuracy and safety

作者：Yaffe Daniel; Koslow Matthew^*; Haskiya Hassan; Shitrit David

来源：European Radiology, 2015, 25(11): 3354-3360.

DOI：10.1007/s00330-015-3750-z

• Computed tomography (CT), guidance
• Lung biopsy
• Lung neoplasms, diagnosis
• Lung cancer, diagnosis
• Pneumothorax

To present the diagnostic accuracy and safety of a novel technique for CT-guided transthoracic needle aspiration biopsy (TNAB) of lung lesions suspected of malignancy.
A novel technique for coaxial CT-guided TNAB is reported in this single-centre, retrospective study. A 22-gauge guide wire is used to accurately locate the lesion prior to biopsy. The technique enables penetration of lung lesions in various locations with less risk of harm to adjacent organs. Malignant and benign diagnoses were confirmed by histology or radiologic resolution.
Clinical features of 181 patients included 59 % men. Mean lesion size was 24 +/- 14.9 mm with a mean depth of 13.6 +/- 18.3 mm. Among 160 (88.4 %) confirmed malignancies, 151 (94.4 %) were diagnosed with TNAB. Among the 13 (7.2 %) confirmed benign diagnoses, 11 (84.6 %) received a specific, benign diagnosis with TNAB. The overall diagnostic accuracy of CT-TNAB was 93.6 % among all confirmed diagnoses (173/181). Complications included 48 (26.5 %) with pneumothorax, of which 77.8 % resolved spontaneously, 20 % by aspiration and 2.2 % required chest drain insertion. Intrapulmonary haemorrhage was observed in 3.9 % and hemoptysis in 6.0 % without clinical significance.
The guide wire technique provides a novel method for needle biopsy of lung lesions with improved accuracy and safety.
Lung cancer screening has increased the detection of lung lesions.
The guide wire technique is a novel method to biopsy lung lesions.
The guide wire technique for lung biopsy demonstrates improved accuracy and safety.
The chest tube insertion rate is reduced with aspiration during the procedure.

• 出版日期2015-11