CT-guided percutaneous lung biopsy in children.
OBJECTIVE
To describe techniques and evaluate outcomes of computed tomography (CT)-guided percutaneous lung biopsy in children.


METHODS
Between April 1992 and June 2003, 64 patients (32 male, 32 female) with a mean age of 10.8 years (0.6-20 years) were referred for 75 lung biopsies. Most biopsies were performed for suspected malignancy (n = 24; 32%) or to distinguish posttransplantation lymphoproliferative disorder from fungal infection in immunocompromised patients (n = 17; 23%). All children referred to the pediatric interventionalists in two children's hospitals for CT-guided biopsy of parenchymal or pleural-based lesions in the thorax were studied. Prospectively gathered procedural data were reviewed for medical history and indications for procedure, admission status, type of anesthesia, technical approach (core vs aspiration biopsy), procedural modifications, lesion size, number of passes required, and immediate complications. Medical records were retrospectively reviewed for diagnostic outcome, impact on patient management, and delayed complications.


RESULTS
Procedures were performed under deep sedation whenever possible (n = 61; 81%) with use of a coaxial core biopsy technique (n = 56; 75%), a fine needle aspiration biopsy technique (n = 15; 20%), or both (n = 4; 5%). Mean lesion diameters were 2.5 cm (range, 1-10 cm) in the core biopsy group and 1.0 cm (range, 0.5-1.7 cm) in the aspiration biopsy group. Sixty-four biopsies (85%) were diagnostic. There was one major complication (1.3%), a tension pneumothorax treated with intraprocedural placement of a chest tube.


CONCLUSIONS
Percutaneous CT-guided lung biopsy is a safe and accurate diagnostic procedure in children that obviates open surgical biopsy in most patients.
Cahill
Anne Marie
AM
Department of Radiology, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA. cahill@email.chop.edu
Baskin
Kevin M
KM
Kaye
Robin D
RD
Fitz
Charles R
CR
Towbin
Richard B
RB
D000293:Adolescent; D000328:Adult; D001706:Biopsy / Q000295:instrumentation / Q000379:methods*; D044963:Biopsy, Fine-Needle / Q000379:methods; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D008172:Lung Diseases, Fungal / Q000473:pathology; D008175:Lung Neoplasms / Q000473:pathology; D008232:Lymphoproliferative Disorders / Q000473:pathology; D008297:Male; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed