Content area
Abstract
Background
This article aims to comprehensively describe indications, contraindications, technical aspects, diagnostic accuracy and complications of percutaneous lung biopsy.
Methods
Imaging-guided biopsy currently represents one of the predominant methods for obtaining tissue specimens in patients with lung nodules; in many cases treatment protocols are based on histological information; thus, biopsy is frequently performed, when technically feasible, or in case other techniques (such as bronchoscopy with lavage) are inconclusive.
Results
Although a coaxial system is suitable in any case, two categories of needles can be used: fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB), with the latter demonstrated to have a slightly higher overall sensitivity, specificity and accuracy.
Conclusion
Percutaneous lung biopsy is a safe procedure even though a few complications are possible: pneumothorax, pulmonary haemorrhage and haemoptysis are common complications, while air embolism and seeding are rare, but potentially fatal complications.
Teaching points
* Imaging-guided biopsy is one of the main methods to obtain lung nodule specimens.
* CT has the highest accuracy for diagnosis as an imaging guide.
* Compared to FNAB, CNB has a higher accuracy for diagnosis.
* Pneumothorax and parenchymal pulmonary haemorrhage care the most frequent complications.
* Several clinical and technical variables can affect diagnostic accuracy and patient safety.
Details
1 Department of Radiological, Oncological and Anatomopathological Sciences, Radiology, Sapienza, University of Rome, Rome, Italy
2 Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari, Polo di Monserrato, Italy