title: A novel technique for CT-guided transthoracic biopsy of lung lesions: improved biopsy accuracy and safety.
abstract: OBJECTIVE
  To present the diagnostic accuracy and safety of a novel technique for CT-guided transthoracic needle aspiration biopsy (TNAB) of lung lesions suspected of malignancy.
  
  
  METHODS
  A novel technique for coaxial CT-guided TNAB is reported in this single-centre, retrospective study. A 22-gauge guide wire is used to accurately locate the lesion prior to biopsy. The technique enables penetration of lung lesions in various locations with less risk of harm to adjacent organs. Malignant and benign diagnoses were confirmed by histology or radiologic resolution.
  
  
  RESULTS
  Clinical features of 181 patients included 59% men. Mean lesion size was 24 ± 14.9 mm with a mean depth of 13.6 ± 18.3 mm. Among 160 (88.4%) confirmed malignancies, 151 (94.4%) were diagnosed with TNAB. Among the 13 (7.2%) confirmed benign diagnoses, 11 (84.6%) received a specific, benign diagnosis with TNAB. The overall diagnostic accuracy of CT-TNAB was 93.6% among all confirmed diagnoses (173/181). Complications included 48 (26.5%) with pneumothorax, of which 77.8% resolved spontaneously, 20% by aspiration and 2.2% required chest drain insertion. Intrapulmonary haemorrhage was observed in 3.9% and hemoptysis in 6.0% without clinical significance.
  
  
  CONCLUSIONS
  The guide wire technique provides a novel method for needle biopsy of lung lesions with improved accuracy and safety.
  
  
  CONCLUSIONS
  Lung cancer screening has increased the detection of lung lesions. The guide wire technique is a novel method to biopsy lung lesions. The guide wire technique for lung biopsy demonstrates improved accuracy and safety. The chest tube insertion rate is reduced with aspiration during the procedure.
authors.affiliation: Department of Diagnostic Radiology, Meir Medical Center, Kfar Saba, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Daniel
authors.initials: D
authors.lastname: Yaffe
authors.affiliation: Pulmonary Department, Meir Medical Center, 59 Tschernikovsky St., Kfar Saba, 44281, Israel. mkoslow73@gmail.com.
authors.forename: Matthew
authors.initials: M
authors.lastname: Koslow
authors.affiliation: Department of Diagnostic Radiology, Meir Medical Center, Kfar Saba, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Hassan
authors.initials: H
authors.lastname: Haskiya
authors.affiliation: Pulmonary Department, Meir Medical Center, 59 Tschernikovsky St., Kfar Saba, 44281, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Shitrit
mesh_terms: D000368:Aged; D001707:Biopsy, Needle / Q000379:methods; D015505:Chest Tubes; D055088:Early Detection of Cancer / Q000295:instrumentation / Q000379:methods; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006652:Histological Techniques; D006801:Humans; D061705:Image-Guided Biopsy / Q000295:instrumentation / Q000379:methods; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D061214:Patient Safety; D011030:Pneumothorax / Q000209:etiology / Q000503:physiopathology; D015641:Radiography, Interventional / Q000379:methods; D011871:Radiology / Q000295:instrumentation; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D014797:Vital Capacity / Q000502:physiology
keywords: Computed tomography (CT), guidance; Lung cancer, diagnosis; Lung neoplasms, diagnosis; Lung, biopsy; Pneumothorax