Analysing percutaneous lung biopsy
posted on August 11, 2017

The authors of this article deliver a complete depiction of percutaneous lung biopsy: comprehensively described indications, contraindications, technical aspects, diagnostic accuracy and complications.

Teaching points:

  • Imaging-guided biopsy is one of the main methods to obtain lung nodule specimens.
  • CT has the highest accuracy for diagnosis as an imaging guide.
  • Compared to FNAB, CNB has a higher accuracy for diagnosis.
  • Pneumothorax and parenchymal pulmonary haemorrhage care the most frequent complications.
  • Several clinical and technical variables can affect diagnostic accuracy and patient safety.

Abstract:

Background
This article aims to comprehensively describe indications, contraindications, technical aspects, diagnostic accuracy and complications of percutaneous lung biopsy.

Methods
Imaging-guided biopsy currently represents one of the predominant methods for obtaining tissue specimens in patients with lung nodules; in many cases treatment protocols are based on histological information; thus, biopsy is frequently performed, when technically feasible, or in case other techniques (such as bronchoscopy with lavage) are inconclusive.

Results
Although a coaxial system is suitable in any case, two categories of needles can be used: fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB), with the latter demonstrated to have a slightly higher overall sensitivity, specificity and accuracy.

Conclusion
Percutaneous lung biopsy is a safe procedure even though a few complications are possible: pneumothorax, pulmonary haemorrhage and haemoptysis are common complications, while air embolism and seeding are rare, but potentially fatal complications.

Reference:

Anzidei, M., Porfiri, A., Andrani, F. et al. Insights Imaging (2017) 8: 419. https://doi.org/10.1007/s13244-017-0561-6



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