Diagnostic yield and complications of CT-guided biopsy of lung lesions as a radiological outpatient clinic procedure
Katrine Bitsch Johansen, John Valtersson, Christian B. Laursen, Bo Redder Mussmann, Benjamin Schnack Rasmussen, Ole Graumann, Pia Iben Pietersen
Abstract
Background: Computerized tomography-guided transthoracic needle biopsy (CT-TTNB) plays an important role in the diagnostic work-up of lung lesions. The literature reports varying results on complication rates, severity of complications, and diagnostic yield. Purpose: To evaluate CT-TTNB as a radiological outpatient clinic procedure and explore diagnostic yield and complication rates. Material and methods: Between January 2017 and October 2019, a total of 559 patients underwent CT-TTNB. Patient records and CT scans were retrospectively reviewed and patient characteristics, lesion characteristics, biopsy procedure, and per- and post-procedural complications, as well as pathological diagnosis, were registered. Results: = 275 of 559 patients). Insertion of a drainage catheter was needed in 85 of the 275 patients with pneumothorax. Parenchymal bleeding was seen in 26.5% of the patients and haemoptysis in 5.5%. No cases of bleeding or haemoptysis required intervention or admission. Small mean lesion size and increased distance from pleura to the lesion were associated with a higher occurrence of complications. A conclusive pathological diagnosis was obtained in 278 of 511 (54.4%) biopsies. No patients were re-admitted after the two-hour observational period in the radiological department. Conclusion: CT-TTNB as an outpatient clinic procedure is feasible but has a moderate diagnostic yield and relatively high complication rates for minor complications.