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.
• 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.
Viggiano RW, Swensen SJ, Rosenow EC 3rd (1992) Evaluation and management of solitary and multiple pulmonary nodules. Clin Chest Med 13(1):83–95 PubMed
Momen M. Wahidi, Joseph A. Govert, Ranjit K. Goudar, et al. Evidence for the Treatment of Patients With Pulmonary Nodules: When Is It Lung Cancer? ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition)
Gould MK, Maclean CC, Kuschner WG, Rydzak CE, Owens DK Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions: a meta-analysis. JAMA 2001;21;285(7):914–24
Higashi K, Ueda Y, Seki H, Yuasa K, Oguchi M, Noguchi T, Taniguchi M, Tonami H, Okimura T, Yamamoto I (1998) Fluorine-18-FDG PET imaging is negative in bronchioloalveolar lung carcinoma. J Nucl Med 39(6):1016–1020 PubMed
Nosari A, Anghilieri M, Carrafiello G, Guffanti C et al (2003) Utility of percutaneous lung biopsy for diagnosing filamentous fungal infections in hematologic malignancies. Haematologica 88(12):1405–1409 PubMed
Carrafiello G, Laganà D, Nosari AM, Guffanti C et al (2006) Utility of computed tomography (CT) and of fine needle aspiration biopsy (FNAB) in early diagnosis of fungal pulmonary infections. Study of infections from filamentous fungi in haematologically immunodeficient patients. Radiol Med 111(1):33–41 CrossRefPubMed
Raptakis T, Boura P, Tsimpoukis S, Gkiozos I, Syrigos KN (2013) Endoscopic and endobronchial ultrasound-guided needle aspiration in the mediastinal staging of non-small cell lung cancer. Anticancer Res 33(6):2369–2376 PubMed
Romanes GJ (1981) Cunningham’s textbook of anatomy. Oxford University Press, London
CollingsCL WJL, BansonNL LRC (1999) Pneumothorax and dependent versus nondependent patient position after needle biopsy of the lung. Radiology 210(1):59–64 CrossRef
YamagamiT NT, Iida S, Kato T, Nishimura T (2002) Management of pneumothorax after percutaneous CT-guided lung biopsy. Chest 121(4):1159–1164 CrossRef
Sinner WN (1976) Complications of percutaneous transthoracic needle aspiration biopsy. Acta Radiol Diagn (Stockh) 17(6):813–828 CrossRef
Berquist TH, Bailey PB, Cortese DA et al (1980) Transthoracic needle biopsy: accuracy and complications in relation to location and type of lesion. Mayo Clin Proc 55:475–481 PubMed
Kim GR, Hur J, Lee SM et al (2011) CT fluoroscopy-guided lung biopsy versus conventional CT-guided lung biopsy: a prospective controlled study to assess radiation doses and diagnostic performance. Eur Radiol
- Imaging-guided chest biopsies: techniques and clinical results
Michele Di Martino
- Springer Berlin Heidelberg
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