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

  • Chest
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Abstract

Objectives

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.

Methods

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.

Results

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.

Conclusion

The guide wire technique provides a novel method for needle biopsy of lung lesions with improved accuracy and safety.

Key Points

  • 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.

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Abbreviations

CT:

Computed tomography

TNAB:

Transthoracic needle aspiration biopsy

FNA:

Fine-needle aspiration

FEV1:

Forced expiratory volume in 1 second

FVC:

Forced vital capacity

COPD:

Chronic obstructive pulmonary disease

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Acknowledgements

We thank Dr. Nira Koren for assistance with the statistical analyses. The scientific guarantor of this publication is Prof. David Shitrit, M.D. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Institutional Review Board approval was obtained (0164-13-MMC) from the Meir Medical Center. Written informed consent was obtained from all subjects for the procedure but waived by the IRB for the analysis in this retrospective study. None of the study subjects have been previously reported. Methodology: retrospective, observational, performed at one institution.

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    Authors and Affiliations

    1. Department of Diagnostic Radiology, Meir Medical Center, Kfar Saba, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

      Daniel Yaffe & Hassan Haskiya

    2. Pulmonary Department, Meir Medical Center, 59 Tschernikovsky St., Kfar Saba, 44281, Israel

      Matthew Koslow & David Shitrit

    Authors
    1. Daniel Yaffe
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    2. Matthew Koslow
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    3. Hassan Haskiya
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    4. David Shitrit
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    Correspondence to Matthew Koslow.

    Additional information

    Daniel Yaffe and Matthew Koslow contributed equally to this work.

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    Yaffe, D., Koslow, M., Haskiya, H. et al. A novel technique for CT-guided transthoracic biopsy of lung lesions: improved biopsy accuracy and safety. Eur Radiol 25, 3354–3360 (2015). https://doi.org/10.1007/s00330-015-3750-z

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    • DOI: https://doi.org/10.1007/s00330-015-3750-z

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