Andy Shau-Bin Chou, Presenter: Nothing to Disclose

Pau-Yang Chong, Abstract Co-Author: Nothing to Disclose

Chau-Chin Lee, Abstract Co-Author: Nothing to Disclose

To evaluate the usefulness and complication of CT-guide transthoracic large-bore coaxial cutting biopsy (16-G) by automated biopsy gun in patients with pulmonary lesions.

From November 1th, 2000 to October 31th, 2001, 71 biopsies were performed on 70 patients with pulmonary lesions under CT-guidance with 16-G coaxial biopsy system. Single radiologist did all the procedures. 24 out-patients and 56 ward-patients were enrolled in this study. 42 male and 28 female patients were enrolled within the study, from 22 to 89 year-old (mean age of 62.97). 30 peripheral lesions were requested for biopsy. Another 58 lesions were requested for biopsy due to inadequate bronchoscopic results. Adequacy of specimen, accuracy of diagnosis, and post-biopsy complication (such as pneumothorax, parenchymal hemorrhage, patient mobility, and mortality) were evaluated.

Target lesion size ranged from 1.7 cm to 12 cm in size with mean of 4.63 cm. The needle paths were all only once through liver. Cutting specimens ranged from one cut (1/71, 1.4%), two cuts (3/71, 4%), three cuts (26/71, 36.6%), four cuts (27/71, 38%), five cuts (13/71, 18.3%), and six cuts (1/71, 1.4%). The pathologist considered all the specimens adequate by gross inspection. Fifty-one cutting biopsies (51/71, 71.8%) had malignant results. Twenty cutting biopsies (20/71, 28.2%) had benign results. No false positive or false negative is noted. The post-biopsy pneumothoraces were noted in seventeen patients (17/70, 24.3%). The post-biopsy parenchymal hemorrhage was noted in seventeen patients (17/70, 24.3%). Only two patients had hemoptysis (2/17, 11.8%), all less than 30 ml in amount. No patient experienced dyspnea and needed treatment. No pig-tail or chest tube insertion was needed to relieve patient’s pneumothorax. No post-biopsy mortality was noted.

CT-guide transthoracic large-bore coaxial cutting biopsy (16-G) by automated biopsy gun in patients with pulmonary lesions is useful for pathological prove for peripheral lesions and lesions with inadequate bronchoscopic results. As compared with other literature, the rate of pneumothorax in this study was 24% that was low in profile as in the world series of 5 to 60%.

Chou, A, Chong, P, Lee, C, CT-guided Transthoracic Large-bore Coaxial Cutting Biopsy (16-G) by Automated Biopsy Gun.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4405544.html