Intrapulmonary lesions: percutaneous automated biopsy with a detachable, 18-gauge, coaxial cutting needle.
OBJECTIVE
To evaluate a lung biopsy technique in which a detachable, 18-gauge, coaxial guide around a central notched stylet is used as a cutting needle.


METHODS
The records of 89 consecutive patients (41 women, 48 men; aged 21-86 years) who underwent coaxial percutaneous core biopsy of 91 lung lesions that required needle passage through normal lung tissue (mean lesion size, 33.6 mm; range, 9-80 mm) were studied. Detachable, 18-gauge, coaxial automated cutting needles were used.


RESULTS
The mean number of needle passes was 2.5 (range, 1-4). All biopsies yielded sufficient tissue for histopathologic (n = 91) and, if necessary, bacteriologic (n = 12) evaluation (mean core length, 5 mm; range, 1-15 mm). Eighty-nine lesions had definitive diagnoses. Seventy-five lesions were proved to be malignant; seventy (93%) could be accurately diagnosed with coaxial percutaneous core biopsy samples. Fourteen lesions were proved to be benign; 10 (71%) were specifically diagnosed with biopsy samples. Among the 91 biopsies, the overall diagnostic accuracy was 88% (80 of 91 lesions). A pneumothorax occurred in 31 cases (34%), three (3%) of which necessitated placement of a chest tube. Postbiopsy hemoptysis occurred and resolved spontaneously in nine cases (10%).


CONCLUSIONS
This technique provides a core biopsy specimen without the need for an on-site cytopathologist during the procedure. It has a high diagnostic accuracy and an acceptable rate of complications.
Lucidarme
O
O
Department of Radiology, Hôpital de la Pitié-Salpêtrère, Paris, France.
Howarth
N
N
Finet
J F
JF
Grenier
P A
PA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009339:Needles; D015641:Radiography, Interventional / Q000295:instrumentation / Q000379:methods; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods