CT-guided percutaneous core needle biopsy of pulmonary nodules smaller than 2 cm: technical aspects and factors influencing accuracy

• Published in: Jornal brasileiro de pneumologia Vol. 44; no. 4; pp. 307 - 314
• Main Authors: Andrade, Juliano Ribeiro de, Rocha, Rafael Dahmer, Falsarella, Priscila Mina, Rahal Junior, Antonio, Santos, Ricardo Sales Dos, Franceschini, Juliana Pereira, Fernando, Hiran Chrishantha, Garcia, Rodrigo Gobbo
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Sociedade Brasileira de Pneumologia e Tisiologia 01.08.2018
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy, Large-Core Needle - adverse effects; Biopsy, Large-Core Needle - methods; Biópsia guiada por imagem; Child; Child, Preschool; Female; Hemorrhage - etiology; Humans; Image-Guided Biopsy - adverse effects; Image-Guided Biopsy - methods; Lung Neoplasms - pathology; Male; Middle Aged; Multiple Pulmonary Nodules - pathology; Neoplasias; Original; Pneumothorax - etiology; Pulmão; RESPIRATORY SYSTEM; Retrospective Studies; Risk Factors; Solitary Pulmonary Nodule - pathology; Tomography, X-Ray Computed; Young Adult; Neoplasias; Image-guided biopsy; Pulmão; Lung; Neoplasms; Biópsia guiada por imagem
• ISSN: 1806-3713; 1806-3756; 1806-3756
• DOI: 10.1590/s1806-37562017000000259

To evaluate the diagnostic accuracy of CT-guided percutaneous core needle biopsy (CT-CNB) of pulmonary nodules ≤ 2 cm, as well as to identify factors influencing the accuracy of the procedure and its morbidity. This was a retrospective, single-center study of 170 consecutive patients undergoing CT-CNB of small pulmonary nodules (of ≤ 2 cm) between January of 2010 and August of 2015. A total of 156 CT-CNBs yielded a definitive diagnosis, the overall diagnostic accuracy being 92.3%. Larger lesions were associated with a higher overall accuracy (OR = 1.30; p = 0.007). Parenchymal hemorrhage occurring during the procedure led to lower accuracy rates (OR = 0.13; p = 0.022). Pneumothorax was the most common complication. A pleura-to-lesion distance > 3 cm was identified as a risk factor for pneumothorax (OR = 16.94), whereas performing a blood patch after biopsy was a protective factor for pneumothorax (OR = 0.18). Small nodules (of < 2 cm) represent a technical challenge for diagnosis. CT-CNB is an excellent diagnostic tool, its accuracy being high.