Percutaneous CT-guided cutting needle biopsy of pulmonary lesions. Retrospective analysis of 153 procedures

Background: CT guided percutaneous biopsy of pulmonary lesions is a widely used technique. Aim: To evaluate the yield and complication rate of CT-guided percutaneous core biopsy of pulmonary lesions. Material and Methods: A retrospective study of 153 consecutive lung biopsies performed in a 7-year period was undertaken. Patients and lesions characteristics were reviewed. The yield for the diagnosis of malignant and benign lesions and the complication rate were calculated. Lesion size and depth from the pleural surface were analyzed as potential predictive variables for occurrence of a false-negative diagnosis of malignancy. The final diagnosis was established by surgical biopsy of the lesion or clinical and imaging follow up. Results: The mean age of patients was 66 +/- 14 years and 55% were male. The final diagnosis of the lesion was malignant in 139 and benign in 14 cases (prevalence of malignancy 90.8%). For the diagnosis of malignancy, the overall yield of the biopsy was 91.5% with a sensitivity of 90.6%. A specific diagnosis of benign lesions was obtained in 5 out of 14 biopsies (35%). We did not identify an association between the lesion size or depth and the rate of false-negative diagnosis of malignancy. The pneumothorax rate was 13.7% (n = 21) and eight (38%) required drainage. The average lesion depth of patients that had a pneumothorax was significant greater than the cases without the complication. No major bleeding complications occurred. Conclusions: Percutaneous CT-guided cutting needle biopsies of pulmonary lesions have an excellent diagnostic accuracy for malignant pulmonary lesions, at a low complication rate.