CT-guided cutting needle biopsy of lung lesions - Safety and efficacy of an out-patient service

AIM: To determine the safety and efficacy of CT-guided cutting needle biops y of lung lesions as an out-patient procedure. MATERIALS AND METHODS: A total of 185 consecutive biopsies were performed u nder CT guidance on 183 patients between January 1991 and December 1998 usi ng 20-gauge (n = 33), 18-gauge (n = 151) or 14-gauge (n = 1) core biopsy ne edles. A chest radiograph was taken after observation in the Radiology depa rtment for I h and asymptomatic patients were discharged. RESULTS: The histology was malignant in 150 biopsies (81.1%) and benign in 23 (12.4%) with 12 false-negative results (6.5%); there were no false-posit ive results, The sensitivity was 92.6%; specificity 100%; negative predicti ve value 65.7%; and overall accuracy 93.5%. Pneumothoraces occurred in 48 p atients (25.9%); one required aspiration only and four required insertion o f an intercostal drain. One patient developed a pneumothorax after discharg e, Small haemoptyses occurred in 13 patients without pneumothorax (7.0%), o ne of whom was admitted, In-patient treatment was required in 10 patients ( 5.4%). CONCLUSION: Computed tomography-guided cutting needle biopsy of pulmonary l esions is a safe technique with a diagnostic accuracy and complication rate comparable to reported figures for fine needle aspiration biopsy. It can b e safely performed on an out-patient basis, Charig, M. J., Phillips, A. J. (2000). Clinical Radiology 55, 964-969. (C) 2000 The Royal College of Radio logists.