Diagnostic Techniques and Limitations : CT-Guided Percutaneous Lung Biopsy
▲CT - guided percutaneous transthoracic core biopsy and/or fiducial marker placement are accepted and widely used methods of establishing the etiology of lung masses and/or assisting in treatment
▲Procedure is overall safe; limited associated morbidity and extremely rare mortality
▲Pneumothorax (PTX) remains the most frequent complication
▲Frequency of PTX for CT-guided procedures varies from 8% to 64%
- 1.6% to 17% of these pneumothoraces are significant enough to require chest tube placement
|
|
Technique |
Sensitivity |
Specificity |
False |
False |
Limiting Factor |
|
Sputum Cytology |
66% |
99% |
8% |
10% |
Rigorous sampling Variable SN / SP |
|
Flexible Bronchoscopy |
34% (< 2cm) 63% (> 2cm) |
78% (Peripheral) 88% (Central) |
-- |
-- |
Sampling size Mass size (> 2cm) |
|
Radial Endoscopic |
73% |
100% |
-- |
-- |
Lower SN for lesion < 2cm Pneumothorax |
|
Trans-thoracic Needle |
90% |
97% |
1% |
22% |
Pneumothorax Hemorrhage |