J Korean Soc Radiol.  2011 Oct;65(4):373-379. 10.3348/jksr.2011.65.4.373.

CT Fluoroscopy-Guided Core Biopsy for Diagnosis of Small (< or = 20 mm) Pulmonary Nodules

• Lee HL
• Kim YK
• Woo OH
• Yong HS
• Kang EY
• Kim HK
• Shin BK

• KMID: 2002938
• DOI: http://doi.org/10.3348/jksr.2011.65.4.373

Abstract

PURPOSE
To evaluate the efficacy of CT fluoroscopy-guided core biopsy of small pulmonary nodules.
MATERIALS AND METHODS
This study included 62 patients (35 men, 27 women; age range, 36-85 years) that had a small (< or = 20 mm) pulmonary nodule and underwent CT fluoroscopy-guided core biopsy. The overall diagnostic accuracy and complication rate were calculated. The diagnostic accuracy was compared between two groups according to the nodule size (< or = 10 mm vs. > 10 mm), and nodule density (solid vs. subsolid).
RESULTS
Malignant or premalignant lesions were finally diagnosed in 39 patients; 36 true-positive and three false-negative findings (sensitivity, 92%). A benign lesion was finally diagnosed in 23 patients, with no false-positive results (specificity, 100%). The overall diagnostic accuracy was 95%. The sensitivity and diagnostic accuracy were 85% and 91% for nodules < or = 10 mm, and 96% and 97% for nodules > 10 mm (p > 0.05). The sensitivity and diagnostic accuracy were 93% and 96% in the solid group and 90% and 92% in the subsolid group (p > 0.05). Seventeen (27%) patients had a pneumothorax and two (3%) required a closed thoracostomy.
CONCLUSION
CT fluoroscopy-guided core biopsy of small pulmonary nodules yields high diagnostic accuracy with acceptable complication rates.

MeSH Terms

Biopsy
Biopsy, Needle
Humans
Lung Neoplasms
Male
Pneumothorax

Figure

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  Fig. 1 CT fluoroscopy-guided core biopsy in a 59-year-old woman. A. A 1 cm-sized subsolid nodule is seen in the right upper lobe. B. CT scan obtained during biopsy shows needle targeting of the nodule. C. Post-biopsy CT scan shows pulmonary hemorrhage along the needle passage. The histopathological diagnosis by biopsy was bronchioloalveolar carcinoma confirmed by surgery.

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