CT-guided cutting needle biopsy of lung lesions--safety and efficacy of an out-patient service

Clin Radiol. 2000 Dec;55(12):964-9. doi: 10.1053/crad.2000.0964.


Aim: To determine the safety and efficacy of CT-guided cutting needle biopsy of lung lesions as an out-patient procedure.

Materials and methods: A total of 185 consecutive biopsies were performed under CT guidance on 183 patients between January 1991 and December 1998 using 20-gauge (n= 33), 18-gauge (n= 151) or 14-gauge (n= 1) core biopsy needles. A chest radiograph was taken after observation in the Radiology department for 1 h and asymptomatic patients were discharged.

Results: The histology was malignant in 150 biopsies (81. 1%) and benign in 23 (12.4%) with 12 false-negative results (6.5%); there were no false-positive results. The sensitivity was 92.6%; specificity 100%; negative predictive value 65.7%; and overall accuracy 93.5%. Pneumothoraces occurred in 48 patients (25.9%); one required aspiration only and four required insertion of an intercostal drain. One patient developed a pneumothorax after discharge. Small haemoptyses occurred in 13 patients without pneumothorax (7.0%), one of whom was admitted. In-patient treatment was required in 10 patients (5.4%).

Conclusion: Computed tomography-guided cutting needle biopsy of pulmonary lesions is a safe technique with a diagnostic accuracy and complication rate comparable to reported figures for fine needle aspiration biopsy. It can be safely performed on an out-patient basis.

MeSH terms

  • Adult
  • Aged
  • Ambulatory Care / methods*
  • Biopsy, Needle / adverse effects
  • Biopsy, Needle / instrumentation
  • Biopsy, Needle / methods*
  • England
  • False Negative Reactions
  • Female
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology*
  • Male
  • Middle Aged
  • Pneumothorax / etiology
  • Radiography, Interventional / methods*
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed*