CT-guided cutting needle biopsy of lung lesions--safety and efficacy of an out-patient service.
OBJECTIVE
To determine the safety and efficacy of CT-guided cutting needle biopsy of lung lesions as an out-patient procedure.


METHODS
A total of 185 consecutive biopsies were performed under CT guidance on 183 patients between January 1991 and December 1998 using 20-gauge (n= 33), 18-gauge (n= 151) or 14-gauge (n= 1) core biopsy needles. A chest radiograph was taken after observation in the Radiology department for 1 h and asymptomatic patients were discharged.


RESULTS
The histology was malignant in 150 biopsies (81. 1%) and benign in 23 (12.4%) with 12 false-negative results (6.5%); there were no false-positive results. The sensitivity was 92.6%; specificity 100%; negative predictive value 65.7%; and overall accuracy 93.5%. Pneumothoraces occurred in 48 patients (25.9%); one required aspiration only and four required insertion of an intercostal drain. One patient developed a pneumothorax after discharge. Small haemoptyses occurred in 13 patients without pneumothorax (7.0%), one of whom was admitted. In-patient treatment was required in 10 patients (5.4%).


CONCLUSIONS
Computed tomography-guided cutting needle biopsy of pulmonary lesions is a safe technique with a diagnostic accuracy and complication rate comparable to reported figures for fine needle aspiration biopsy. It can be safely performed on an out-patient basis.
Charig
M J
MJ
Departments of Radiology, Wexham Park Hospital, Slough, Berkshire, SL2 4HL, U.K.
Phillips
A J
AJ
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000379:methods*; D001707:Biopsy, Needle / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004739:England; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology; D015641:Radiography, Interventional / Q000379:methods*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed