Computed tomography-guided percutaneous needle biopsy of pulmonary nodules: impact of nodule size on diagnostic accuracy

Clin Lung Cancer. 2009 Sep;10(5):360-3. doi: 10.3816/CLC.2009.n.049.


Purpose: This study was undertaken to compare the diagnostic accuracy and complication rate of computed tomography (CT)-guided percutaneous lung biopsies of lung nodules<or=1.5 cm versus >1.5 cm in diameter.

Patients and methods: A total of 139 patients (age range, 18-89 years; mean, 62.5 years) underwent CT-guided percutaneous fine-needle aspiration biopsy or 20-gauge core biopsy using an automated biopsy gun. In 37 patients, the lung nodule measured <or=1.5 cm (mean, 1.1 cm), and in 102 patients, the lung nodule was >1.5 cm (mean, 2.8 cm). Diagnostic accuracy was determined by cytopathology results. Major and minor complications were documented.

Results: Overall diagnostic accuracy, pneumothorax rate, and thoracostomy tube insertion rates were 67.6%, 34.5%, and 5%, respectively. Of the 98 patients with malignancy, 77 patients (78.6%) had a definite diagnostic biopsy. Overall, nodules>1.5 cm were statistically more likely to result in a diagnostic specimen (73.5%) than nodules<or=1.5 cm (51.4%; P=.012). Similarly, diagnostic accuracy for malignancy was higher in nodules>1.5 cm than in those<or=1.5 cm (81.3% vs. 69.6%); however, this was not statistically significant. There was no correlation between nodule size and the incidence of complications.

Conclusion: Overall, diagnostic accuracy of CT-guided percutaneous lung biopsy of lung nodules<or=1.5 cm is slightly lower than that of nodules>1.5 cm. However, the diagnostic accuracy for malignancy is high in both groups, with a low risk of complications.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Cutaneous
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Fine-Needle / adverse effects
  • Biopsy, Fine-Needle / standards*
  • Female
  • Humans
  • Lung / pathology*
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Pneumothorax / etiology
  • Reproducibility of Results
  • Solitary Pulmonary Nodule / diagnosis
  • Solitary Pulmonary Nodule / pathology*
  • Solitary Pulmonary Nodule / surgery
  • Surgery, Computer-Assisted
  • Tomography, X-Ray Computed
  • Tumor Burden