• Vol. 42 No. 6, 285–290
  • 15 June 2013

CT-Guided Thoracic Biopsy: Evaluating Diagnostic Yield and Complications



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Introduction: This study retrospectively evaluated CT-guided thoracic biopsies for diagnostic yield, accuracy and complications.

Materials and Methods: A retrospective analysis of 384 patients (mean age 62.7 years; male/female = 251/133) who underwent 399 CT-guided thoracic biopsies were performed for evaluating diagnostic yield, accuracy and complications. Correlations between patients age, procedure factors (biopsy-needle size, number of passes, lesion-size, lesion-depth and traversed lung-length) and complications such as pneumothorax, haemothorax and haemoptysis were evaluated. A comparison between fi ne needle aspiration (FNA) group and core ± FNA group for diagnostic yield and complications was also performed.

Results: FNA was performed in 349 patients and core ± FNA in 50 patients. The biopsy samples were adequate in 91.9% and the diagnostic accuracy for malignant lesions was 96.8% with 95.7% sensitivity and 100% specificity. Pneumothorax (detected on CT) occurred in 139 cases (34.8%) and only 12 (3.0%) required insertion of an intercostal drain. Mild haemoptysis occurred in 13 patients (3.2%) and small haemothoraces in 2 patients. Pneumothorax occurrence was significantly associated with the traversed lung-length (>3mm), lesion-size (≤33 mm) and lesion-depth (≥60mm) (P <0.05). Haemoptysis occurrence was also significantly associated with traversed lunglength (>3mm) and lesion-size (≤33 mm) (P <0.05). There was no significant difference between diagnostic yield and complication rate between FNA and core ± FNA groups.

Conclusion: CT-guided thoracic biopsy is a safe procedure with high diagnostic yield and low risk of significant complications. Traversed lung-length and smaller lesion size are associated with occurrence of pneumothorax and haemoptysis.

Percutaneous transthoracic needle biopsies which have been performed for more than a century have since gained wide acceptance for diagnosing malignant and benign lung
lesions. Technological advances in computed tomography (CT) have resulted in increased detection of pulmonary and mediastinal masses which are not only detected at an
increased rate but also at smaller sizes. Similarly, we have also seen CT-guided transthoracic biopsies gain widespread acceptance with other modalities such as fluoroscopy being used less frequently as compared to CT.

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