Percutaneous transthoracic CT guided biopsies of lung lesions; fine needle aspiration biopsy versus core biopsy

Abstract

BackgroundThe purpose of this retrospective study was to compare the results and complication rate in CT guided percutaneous trans-thoracic fine needle aspiration biopsies (FNAB) and core biopsies of lung lesions, and to determine the applicability of these needles.Patients and methodsIn 242 patients (166 males; 76 females) with mean age of 58.9 years (13–84 years) CT guided biopsies of lung lesions were performed on dual slice CT equipment. The average diameter of lung lesion was 2.9 cm (1.2–6.3 cm). For FNAB’s 20 – 22 G Chiba needles and for core biopsies 14 G biopsy needles were used. The samples were sent for the histological analysis. The cytological or histological results and the eventual complications were compared.ResultsFNAB’s cytological samples were adequate for definitive diagnosis in 117 patients (79.60 %) and inadequate in 30 patients (20.40 %). Core biopsies samples were adequate in 92 (96.85 %) patients and non- representative (necrotic tissue) in 3 (3.15 %). Pneumothorax as the most frequent complication was detected in 14 (9.7 %) of the patients in the group of FNAB’s and in 30 (31.5 %) of the patients with the core biopsy group.ConclusionsThe results showed that percutaneous transthoracic CT guided biopsies of lung lesions were an effective and safe procedure in the diagnosis of lung lesions. Core biopsy gives a higher percentage of representative samples than FNAB, and is a preferred method regardless of the higher rate of complications.

CT-guided biopsy of pulmonary nodules: is pulmonary hemorrhage a complication or an advantage?

“…omputed tomography (CT)-guided transthoracic fine needle aspiration (TTFNA) biopsy is currently considered a reliable diagnostic technique to assess malignancy of pulmonary nodules and masses (1)(2)(3)(4). CT-guided TTFNA is an invasive technique with low incidence of severe complications and contraindications (1).…”

“…Pneumothorax is the most common complication occurring in the range of 8%-64% (with a risk of tension pneumothorax in about 7% of cases) (1)(2)(3)(4)(5)(6)(7). The risk of pneumothorax increases in the presence of obstructive lung disease and small target lesion.…”

Comparative study of computed tomography guided fine needle aspiration cytology and trucut biopsy in diagnosis of lung cancer: a report of 81 cases

“…The reported sensitivity of CT guided lung biopsy ranges from 82 to 99%. 15,16 Pain chest and minimal pneumothorax were among the few complications noted but all the patients were managed conservatively without any intervention. The chances of pneumothorax increase with increase in tumor distance from surface and with smaller sized lesions.…”

Pros: After stereotactic ablative radiotherapy for a peripheral early-stage non-small cell lung cancer, radiological suspicion of a local recurrence can be sufficient indication to proceed to salvage therapy

“…Even in patients who have not undergone radiation in the past, the performance characteristics of CT-guided biopsies may be suboptimal. In a retrospective analysis of 242 patients, CT-guided fine needle aspiration biopsies (CT-FNAB) failed to achieve a definitive diagnosis in 20% of cases (inadequate tissue) compared with only a 3% nondiagnostic rate with CT-guided core biopsies (CT-CB) (12). Although highly specific (99.1%), CT-CB are prone to false negatives, with a reported negative predictive value of only 73.3% (13).…”