title: CT-guided thoracic biopsy: evaluating diagnostic yield and complications.
abstract: BACKGROUND
  This study retrospectively evaluated CT-guided thoracic biopsies for diagnostic yield, accuracy and complications.
  
  
  METHODS
  A retrospective analysis of 384 patients (mean age 62.7 years; male/female = 251/133) who underwent 399 CT-guided thoracic biopsies were performed for evaluating diagnostic yield, accuracy and complications. Correlations between patients age, procedure factors (biopsy-needle size, number of passes, lesion-size, lesion-depth and traversed lung-length) and complications such as pneumothorax, haemothorax and haemoptysis were evaluated. A comparison between fine needle aspiration (FNA) group and core ± FNA group for diagnostic yield and complications was also performed.
  
  
  RESULTS
  FNA was performed in 349 patients and core ± FNA in 50 patients. The biopsy samples were adequate in 91.9% and the diagnostic accuracy for malignant lesions was 96.8% with 95.7% sensitivity and 100% specificity. Pneumothorax (detected on CT) occurred in 139 cases (34.8%) and only 12 (3.0%) required insertion of an intercostals drain. Mild haemoptysis occurred in 13 patients (3.2%) and small haemothoraces in 2 patients. Pneumothorax occurrence was significantly associated with the traversed lung-length (>3mm), lesion-size (≤33 mm) and lesion-depth (≥60mm) (P <0.05). Haemoptysis occurrence was also significantly associated with traversed lunglength (>3mm) and lesion-size (≤33 mm) (P <0.05). There was no significant difference between diagnostic yield and complication rate between FNA and core ± FNA groups.
  
  
  CONCLUSIONS
  CT-guided thoracic biopsy is a safe procedure with high diagnostic yield and low risk of significant complications. Traversed lung-length and smaller lesion size are associated with occurrence of pneumothorax and haemoptysis.
authors.affiliation: Department of Diagnostic Imaging, National University Hospital, Singapore.
authors.forename: Stanley E K
authors.initials: SE
authors.lastname: Loh
authors.forename: Donald D F
authors.initials: DD
authors.lastname: Wu
authors.forename: Sudhakar K
authors.initials: SK
authors.lastname: Venkatesh
authors.forename: Cheng Kang
authors.initials: CK
authors.lastname: Ong
authors.forename: Eugene
authors.initials: E
authors.lastname: Liu
authors.forename: Kar Yin
authors.initials: KY
authors.lastname: Seto
authors.forename: Anil
authors.initials: A
authors.lastname: Gopinathan
authors.forename: Lenny K A
authors.initials: LK
authors.lastname: Tan
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects / Q000379:methods*; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed