CT Guided Transthoracic Lung Biopsy - An Experience from a Tertiary Care Centre Hospital

Abstract

Background: In 1883, Leyden described percutaneous lung biopsy, but it was not until 1970’s that image guided fine needle chest biopsy gained widespread acceptance. Haaga and Alfidi reported CT-guided thoracic biopsy in 1976. Currently, CT-guided core biopsy is playing an increasing role in the diagnosis of benign as well as malignant diseases, cellular differentiation, somatic mutation analysis, and molecular finger print analysis. Small tissue biopsy obtained through minimally invasive methods have become the primary diagnostic tools for the pathologic characterization and testing of lung masses Aim: To evaluate the diagnostic accuracy and complications of CT guided transthoracic lung (core) biopsy in radiologically visible lung lesions Materials and methods: One hundred and one patients who underwent CT guided transthoracic needle aspiration lung biopsy (TNAB) for radiologically visible lung lesions were studied. After obtaining informed consent, the patient was appropriately positioned depending on the site of the lesion. A coaxial 18G biopsy needle (by cook) was used for biopsy. An immediate CT screening was done post procedure to r/o complications. Results: Transthoracic needle aspiration biopsy was diagnostic in 88% (89/ 101) of patients. In case of malignancy even the histological type of tumor was known and adequate tissue was present for molecular sampling. The complication rate (pneumothorax) following CT guided biopsy was 5% (5/101)with 1%(1/101)requiring ICD insertion. One patient had minimal haemoptysis which subsided with conservative management. Conclusion: CT guided lung biopsy is a safe, cost effective and useful procedure for determination of different lung lesions with diagnostic challenge. The complication rates are very few in experienced hands.

Keywords

• ct auided transthoracic luna bioosv. diaanostic accuracy
• cost effective
• complication rate