Outcomes of CT-Guided Percutaneous Needle Biopsy for Cavitary Pulmonary Lesions

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Conference Proceeding

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Journal of Vascular and Interventional Radiology


Purpose: Several disease processes ranging from chronic infection to malignant neoplasms may present with cavitary pulmonary nodules. On imaging there may be considerable overlap between benign and malignant cavitary nodules, making it difficult to assess cavitary nodules for malignancy based upon imaging alone. The aim of this study is to evaluate the efficacy, feasibility, and rate of complications of percutaneous transthoracic needle biopsy (PTNB) for cavitary pulmonary nodules. Materials and Methods: A retrospective chart review was conducted of patients that underwent PTNB for cavitary pulmonary lesions at a single institution. Patients were included if they underwent a pulmonary biopsy between July 2014 to July 2021 by diagnostic or interventional radiologists. Biopsy reports, rate of pneumothorax and chest tube utilization, and other relevant complications were collected. Descriptive statistics were then conducted to analyze the collected date. Results: 436 cases of PTNB were isolated after chart review and 58.2% of biopsied pulmonary lesions were found to be malignant. Our diagnostic rate was determined to be 94.1% and our rate of pneumothorax was found to be 24.3%. Chest tubes were inserted in 26.6% of patients with pneumothorax. Conclusion: Based on our data we can conclude that PTNB is a safe, reliable, and efficacious diagnostic method with a low complication rate when used to assess cavitary pulmonary lesions. Our diagnostic rate and rate of pneumothorax is comparable to that of when PTNB is utilized for solitary pulmonary nodules, demonstrating that CT-guided percutaneous transthoracic needle biopsy for cavitary lesions is a feasible option in certain patient populations. Although a commonly performed procedure, improved planning and additional information regarding procedural risks may help decrease the rate of complications associated with PTNB.





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Society of Interventional Radiology Annual Scientific Meeting, March 4-9, 2023, Phoenix, AZ

Society of Thoracic Radiology 2023 Annual Meeting, March 5-8, 2023, Charleston, SC.