Abstract
Introduction
Incidentally detected small pulmonary nodules in patients with an underlying malignancy
most often warrant sampling. Biopsy from such small pulmonary nodules (< 2 cm) is
challenging. In this study, we aim to evaluate the accuracy of computed tomography
(CT)-guided percutaneous core needle biopsy (CNB) of small pulmonary nodules.
Materials and Methods
A total of 169 patients who had CT-guided percutaneous CNB for small pulmonary nodules
(less than 2 cm) between January 2015 and December 2018 were the subjects of this
retrospective, single-center investigation. We determined the success rate of CNB
and the rate of a diagnostic biopsy. Calculations were made for a multivariate study
of the risk variables for complications, such as pneumothorax and pulmonary hemorrhage.
Results
The success rate of lung biopsy, defined by obtaining a sample of pathologically reportable
quality, was 92.9% (157/169). A malignancy was diagnosed in 60.4% of cases (102/169).
Pneumothorax developed in 21.9% cases (37/169), with only 5.3% (9/169) patients requiring
treatment (8 needle aspirations and 1 pigtail catheter drainage). Use of a thicker
(18G) biopsy needle was the only statistically significant predictor of pneumothorax
(odds ratio 2.61, 95% confidence interval 1.24–5.51, p = 0.01). Perifocal hemorrhage was common (72.2%, 122/169) but clinically significant
pulmonary lobar hemorrhage was seen only in 6.5% of the cases (11/169). One patient
required intensive care unit admission due to desaturation from aspiration of blood.
Conclusion
CT-guided biopsy of small pulmonary nodules is safe and feasible with a good success
rate.
Keywords CT-guided biopsy - lung metastasis - small pulmonary nodules
