Transthoracic needle biopsy of small pulmonary nodules

Radiology. 1997 Jan;202(1):97-103. doi: 10.1148/radiology.202.1.8988197.


Purpose: To evaluate the diagnostic accuracy, complications, and usefulness of transthoracic needle biopsy of small pulmonary nodules.

Materials and methods: Between January 1993 and January 1995, 302 patients underwent transthoracic needle biopsy of pulmonary lesions. Sixty-four lesions (in 62 patients) represented small nodules, defined as lesions of 15 mm or less maximum diameter. A total of 75 biopsies were performed in the 64 lesions. Approximately 90% of the biopsies were performed with computed tomographic guidance.

Results: There were 21 benign lesions and 43 cancers (36 primary, seven metastatic). Transthoracic needle biopsy findings were positive for cancer in 40 cases. In all three false-negative lesions, only one biopsy was performed. There were 21 true-negative results and no false-positive results. Positive and negative predictive values were 100% and 88%, respectively. Pneumothorax occurred in 20 (27%) of 75 biopsies, but chest tube placement was necessary in only three cases (4%). Surgery or thoracoscopy was avoided in 31 patients: 17 of 20 patients with benign disease, seven patients with metastatic disease, and seven patients with inoperable lung cancer.

Conclusion: Transthoracic needle biopsy of small pulmonary nodules can produce diagnostic yields comparable with published results of transthoracic needle biopsy of larger lesions.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Needle*
  • False Negative Reactions
  • Female
  • Humans
  • Lung / diagnostic imaging
  • Lung / pathology*
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / diagnostic imaging
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Radiography, Interventional
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed