OBLIQUE PATH - THE OPTIMAL NEEDLE PATH FOR COMPUTED TOMOGRAPHY-GUIDEDBIOPSY OF SMALL SUBPLEURAL LESIONS

Purpose: To determine the optimal needle path for computed tomography (CT)-guided biopsy of small lesions just beneath the pleura. Methods: A biopsy of 61 subpleural lesions measuring less than 2.5 cm was done prospectively with regard to the approach and the results. One of two needle paths was randomly chosen: a nearly right angle path (n = 30) o r an ''oblique path'' in which the needle was sharply inclined within the slice, using a course nearly parallel to the pleura (n = 32). One lesion was sampled twice. The procedures were considered successful wh en diagnostic samples were obtained. Results: The success rate of the oblique path was 81.2% and that of the near 90 degrees path was 43.3% (p < 0.05). Conclusion: For percutaneous biopsy of small subpleural le sions under CT guidance, the oblique path is better than the perpendic ular path.