CT-Guided Thoracic Biopsy: Evaluating Diagnostic Yield and Complications

• Published in: Annals of the Academy of Medicine, Singapore Vol. 42; no. 6; pp. 285 - 290
• Main Authors: Loh, Stanley EK, Wu, Donald DF, Venkatesh, Sudhakar K, Ong, Cheng Kang, Liu, Eugene, Seto, Kar Yin, Gopinathan, Anil, Tan, Lenny KA
• Format: Journal Article
• Language: English
• Published: Singapore 01.06.2013
• Subjects: Adult; Aged; Female; Follow-Up Studies; Humans; Image-Guided Biopsy - adverse effects; Image-Guided Biopsy - methods; Lung Neoplasms - diagnosis; Male; Middle Aged; Postoperative Complications; Reproducibility of Results; Retrospective Studies; Tomography, X-Ray Computed
• ISSN: 0304-4602; 2972-4066; 0304-4602; 2972-4066
• DOI: 10.47102/annals-acadmedsg.V42N6p285

Introduction: This study retrospectively evaluated CT-guided thoracic biopsies for diagnostic yield, accuracy and complications. Materials and Methods: A retrospective analysis of 384 patients (mean age 62.7 years; male/female = 251/133) who underwent 399 CT-guided thoracic biopsies were performed for evaluating diagnostic yield, accuracy and complications. Correlations between patients age, procedure factors (biopsy-needle size, number of passes, lesion-size, lesion-depth and traversed lung-length) and complications such as pneumothorax, haemothorax and haemoptysis were evaluated. A comparison between fine needle aspiration (FNA) group and core ± FNA group for diagnostic yield and complications was also performed. Results: FNA was performed in 349 patients and core ± FNA in 50 patients. The biopsy samples were adequate in 91.9% and the diagnostic accuracy for malignant lesions was 96.8% with 95.7% sensitivity and 100% specificity. Pneumothorax (detected on CT) occurred in 139 cases (34.8%) and only 12 (3.0%) required insertion of an intercostal drain. Mild haemoptysis occurred in 13 patients (3.2%) and small haemothoraces in 2 patients. Pneumothorax occurrence was significantly associated with the traversed lung-length (>3mm), lesion-size (≤33 mm) and lesion-depth (≥60mm) (P <0.05). Haemoptysis occurrence was also significantly associated with traversed lung-length (>3mm) and lesion-size (≤33 mm) (P <0.05). There was no significant difference between diagnostic yield and complication rate between FNA and core ± FNA groups. Conclusion: CT-guided thoracic biopsy is a safe procedure with high diagnostic yield and low risk of significant complications. Traversed lung-length and smaller lesion size are associated with occurrence of pneumothorax and haemoptysis. Key words: Accuracy, Complications, Diagnostic yield, Haemoptysis, Pneumothorax