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21.06.2017 | Review | Ausgabe 4/2017 Open Access

Insights into Imaging 4/2017

Imaging-guided chest biopsies: techniques and clinical results

Insights into Imaging > Ausgabe 4/2017
Michele Anzidei, Andrea Porfiri, Fabrizio Andrani, Michele Di Martino, Luca Saba, Carlo Catalano, Mario Bezzi



This article aims to comprehensively describe indications, contraindications, technical aspects, diagnostic accuracy and complications of percutaneous lung biopsy.


Imaging-guided biopsy currently represents one of the predominant methods for obtaining tissue specimens in patients with lung nodules; in many cases treatment protocols are based on histological information; thus, biopsy is frequently performed, when technically feasible, or in case other techniques (such as bronchoscopy with lavage) are inconclusive.


Although a coaxial system is suitable in any case, two categories of needles can be used: fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB), with the latter demonstrated to have a slightly higher overall sensitivity, specificity and accuracy.


Percutaneous lung biopsy is a safe procedure even though a few complications are possible: pneumothorax, pulmonary haemorrhage and haemoptysis are common complications, while air embolism and seeding are rare, but potentially fatal complications.

Teaching points

• Imaging-guided biopsy is one of the main methods to obtain lung nodule specimens.
• CT has the highest accuracy for diagnosis as an imaging guide.
• Compared to FNAB, CNB has a higher accuracy for diagnosis.
• Pneumothorax and parenchymal pulmonary haemorrhage care the most frequent complications.
• Several clinical and technical variables can affect diagnostic accuracy and patient safety.
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