title: Adequacy and complications of computed tomography-guided core needle biopsy on non-small cell lung cancers for epidermal growth factor receptor mutations demonstration: 18-gauge or 20-gauge biopsy needle.
abstract: BACKGROUND
  To compare adequacy of tissue acquisition for EGFR DNA mutation analysis and the resulting complications in CT-guided lung biopsy cases with either 18-gauge or 20-gauge core biopsy needle.
  
  
  METHODS
  Forty-seven patients with advanced staged non-small cell lung cancers who were failure-treated by conventional chemotherapy were retrospectively reviewed. All had received CT-guided core needle lung biopsy for histology diagnosis and freshly frozen for EGFR mutation analysis before targeted therapy. We compared the complications resulting from these CT-guided lung biopsies and the specimen assessment using 18-gauge (32 patients) or 20-gauge (15 patients) biopsy needle via 17-gauge or 19-gauge coaxial needle.
  
  
  RESULTS
  With an overall pneumothorax rate of 12.8%, pneumothorax occurred in 12.5% and 13.3% of patients by 17-gauge and 19-gauge coaxial needles respectively. The overall rate of hemoptysis was 6.4%, with 6.3% by 18-gauge biopsy needle and 6.6% by 20-gauge biopsy needle. Large peritumoral hemorrhage revealed only in 2 cases of those completed with 18-gauge biopsy needles. 18-gauge biopsy needle obtained larger specimens with heavier weight (average 10.15mg vs 9mg) and higher DNA concentration (average 47.13ng/ul vs 35.92ng/ul) than 20-gauge biopsy needle. Otherwise, the range of optical density (1.67-2.09) was more constant in the specimens by 20-gauge biopsy needles. Mutation demonstration was achieved for all samples.
  
  
  CONCLUSIONS
  CT-guided core needle biopsy is a feasible technique in acquisition of fresh cancer tissues for EGFR gene mutation analysis. The specimen is adequate for gene demonstration either using 18-gauge or 20-gauge tru-cut biopsy needles via 17-gauge or 19-gauge coaxial needles.
authors.affiliation: Department of Imaging & Intervention, Chang Gung Memorial Hospital, 5 Fu Hsing Road, Kwei Shan, Taoyuan, Taiwan.
authors.forename: Yun-Chung
authors.initials: YC
authors.lastname: Cheung
authors.forename: John Wen-Cheng
authors.initials: JW
authors.lastname: Chang
authors.forename: Jia-Juan
authors.initials: JJ
authors.lastname: Hsieh
authors.forename: Gigin
authors.initials: G
authors.lastname: Lin
authors.forename: Ying-Huang
authors.initials: YH
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics / Q000601:surgery*; D004252:DNA Mutational Analysis / Q000295:instrumentation; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D006469:Hemoptysis / Q000209:etiology; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011030:Pneumothorax / Q000209:etiology; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications / Q000209:etiology; D013048:Specimen Handling / Q000295:instrumentation; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D014057:Tomography, X-Ray Computed
chemical_list: D066246:ErbB Receptors