Martin C. Freund MD, Presenter: Nothing to Disclose

Thomas Schmid MD, Abstract Co-Author: Nothing to Disclose

Martin Hackl MD, Abstract Co-Author: Nothing to Disclose

Andreas Gschwendtner MD, Abstract Co-Author: Nothing to Disclose

Bettina Zelger MD, Abstract Co-Author: Nothing to Disclose

Werner R. Jaschke MD, PhD, Abstract Co-Author: Nothing to Disclose

 To assesss the safety and efficacy of percutaneous core biopsy of pulmonary nodules 1 cm in diameter or smaller for histologic evaluation.

CT-guided percutaneous core biopsy was performed in 72 consecutive patients aged 25 - 76 years with 76 small lung nodules. The nodules measured 0.4 – 1.0 cm in diameter (mean 7.8 ± 1.3); all measurements were performed electronically using a commercially available software on a standard desktop PC. CT-guided core biopsy was performed in local (33x) or general anaesthesia (49x) with patient either in supine (27x) or prone (49x) position. An automated biopsy gun with detachable 17G coaxial cutting needle was used with mean number of 7 ± 3 biopsy attempts; length of path through aerated lung parenchyma measured 0.4 – 9.2 cm (mean 3.4 ± 2.3) with needle-pleural angle of 16 – 90 degrees (mean 63 ± 25); dwell time of coaxial needle was 7 – 15 minutes (mean 9.6 ± 4.1) and exposure time using multidetector CT in sequential axial mode was 14 - 39 seconds (mean 24 ± 7.3). In all patients the needle tract was obliterated with fibrin glue.

Core biopsy samples were adequate for histologic diagnosis in 67 (88,2%) of 76 lesions. Diagnosis was malignancy in 32 (49%) and benign findings in 35 (52%) of 67 lesions. Findings were nondiagnostic in 9 (11,8%) of 76 lesions. 11 biopsy procedures performed initially in local anaesthesia had to be repeated in general anaesthesia. Perilesional hemorrhage was observed in all patients and obscured in 58 procedures (78%) the delineation of the lesions during biopsy; no serve hemoptysis was noted. A pneumothorax was detected in 9 of 72 (12,5%) patients, in 4 (5%) patients clinical symptoms required CT-guided percutaneous chest tube placement. One patient died due to myocardial infarction one day after CT-guided biopsy.

CT-guided percutaneous core biopsy of small (≤ 1cm) pulmonary nodules is a safe and effective technique to obtain adequate samples for histologic examination.

CT-guided percutaneous core biopsy of pulmonary nodules 1 cm in diameter or smaller can be performed safely and facilitates reliably histologic assessment.

Freund, M, Schmid, T, Hackl, M, Gschwendtner, A, Zelger, B, Jaschke, W, CT-guided Percutaneous Core Biopsy of Small (≤1-cm) Pulmonary Nodules: Diagnostic Accuracy and Complication Rate.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6008401.html