Adequacy and complications of computed tomography-guided core needle biopsy on non-small cell lung cancers for epidermal growth factor receptor mutations demonstration: 18-gauge or 20-gauge biopsy needle

Lung Cancer. 2010 Feb;67(2):166-9. doi: 10.1016/j.lungcan.2009.04.007. Epub 2009 May 17.


Introduction: To compare adequacy of tissue acquisition for EGFR DNA mutation analysis and the resulting complications in CT-guided lung biopsy cases with either 18-gauge or 20-gauge core biopsy needle.

Methods: Forty-seven patients with advanced staged non-small cell lung cancers who were failure-treated by conventional chemotherapy were retrospectively reviewed. All had received CT-guided core needle lung biopsy for histology diagnosis and freshly frozen for EGFR mutation analysis before targeted therapy. We compared the complications resulting from these CT-guided lung biopsies and the specimen assessment using 18-gauge (32 patients) or 20-gauge (15 patients) biopsy needle via 17-gauge or 19-gauge coaxial needle.

Results: With an overall pneumothorax rate of 12.8%, pneumothorax occurred in 12.5% and 13.3% of patients by 17-gauge and 19-gauge coaxial needles respectively. The overall rate of hemoptysis was 6.4%, with 6.3% by 18-gauge biopsy needle and 6.6% by 20-gauge biopsy needle. Large peritumoral hemorrhage revealed only in 2 cases of those completed with 18-gauge biopsy needles. 18-gauge biopsy needle obtained larger specimens with heavier weight (average 10.15mg vs 9mg) and higher DNA concentration (average 47.13ng/ul vs 35.92ng/ul) than 20-gauge biopsy needle. Otherwise, the range of optical density (1.67-2.09) was more constant in the specimens by 20-gauge biopsy needles. Mutation demonstration was achieved for all samples.

Conclusion: CT-guided core needle biopsy is a feasible technique in acquisition of fresh cancer tissues for EGFR gene mutation analysis. The specimen is adequate for gene demonstration either using 18-gauge or 20-gauge tru-cut biopsy needles via 17-gauge or 19-gauge coaxial needles.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Needle / adverse effects*
  • Biopsy, Needle / instrumentation*
  • Biopsy, Needle / methods
  • Carcinoma, Non-Small-Cell Lung / genetics
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • DNA Mutational Analysis / instrumentation
  • ErbB Receptors / genetics*
  • Female
  • Hemoptysis / etiology
  • Hemorrhage / etiology
  • Humans
  • Lung Neoplasms / genetics
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Mutation
  • Pneumothorax / etiology
  • Polymerase Chain Reaction
  • Postoperative Complications / etiology
  • Specimen Handling / instrumentation
  • Surgery, Computer-Assisted / adverse effects
  • Surgery, Computer-Assisted / instrumentation*
  • Surgery, Computer-Assisted / methods
  • Tomography, X-Ray Computed


  • ErbB Receptors