CT-guided biopsy of lung lesions: defining the best needle option for a specific diagnosis.
OBJECTIVE
To evaluate the performance of fine and cutting needles in computed tomography guided-biopsy of lung lesions suspicious for malignancy and to determine which technique is the best option for a specific diagnosis.


METHODS
This retrospective study reviewed the data from 362 (71.6%) patients who underwent fine-needle aspiration biopsy and from 97 (19.7%) patients who underwent cutting-needle biopsy between January 2006 and December 2011. The data concerning demographic and lesion characteristics, procedures, biopsy sample adequacy, specific diagnoses, and complications were collected. The success and complication rates of both biopsy techniques were calculated.


RESULTS
Cutting-needle biopsy yielded significantly higher percentages of adequate biopsy samples and specific diagnoses than did fine-needle aspiration biopsy (p<0.05). The sensitivity, specificity, and accuracy of cutting-needle biopsy were 93.8%, 97.3%, and 95.2%, respectively; those of fine-needle aspiration biopsy were 82.6%, 81.3%, and 81.8%, respectively (all p<0.05). The incidence of pneumothorax was higher for fine-needle aspiration biopsy, and that of hematoma was higher for cutting-needle biopsy (both p<0.05).


CONCLUSIONS
Our experience using these two techniques for computed tomography-guided percutaneous biopsy showed that cutting-needle biopsy yielded better results than did fine-needle aspiration biopsy and that there was no significant increase in complication rates to indicate the best option for specific diagnoses.
AC Camargo Cancer Center, Department of Imaging, São Paulo, SP, Brazil.
Marcos Duarte
MD
Guimarães
Department of Radiology, Universidade Federal do Rio de Janeiro, Petrópolis, RJ, Brazil.
Edson
E
Marchiori
Department of Radiology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
Bruno
B
Hochhegger
AC Camargo Cancer Center, Department of Imaging, São Paulo, SP, Brazil.
Rubens
R
Chojniak
AC Camargo Cancer Center, Department of Thoracic Surgery, São Paulo, SP, Brazil.
Jefferson Luiz
JL
Gross
D000368:Aged; D001706:Biopsy; D044963:Biopsy, Fine-Needle / Q000295:instrumentation*; D005260:Female; D006801:Humans; D015994:Incidence; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000150:complications; D015641:Radiography, Interventional / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed