CT-guided cutting-needle biopsies of selected chest lesions

Department of Radiology, University Hospitals of Cleveland, OH 44106.

In an effort to improve on our diagnostic yield from percutaneous transthoracic biopsy, we used 14-gauge cutting needles in 56 selected patients. These biopsies were preceded by 18-, 20-, or 22-gauge aspirations in 42 patients, allowing a direct comparison of the efficacy of the needle types. Specific diagnoses were made by cutting-needle biopsy in 78% (25/32) of patients with nonlymphoproliferative malignancies, in 73% (8/11) with lymphoma or thymoma, and in 54% (7/13) of patients with benign diseases. In those in whom both aspiration and cutting needles were employed, a higher percentage of specific diagnoses was achieved by cutting-needle biopsy than by aspiration biopsy: 72% vs 64% in nonlymphoproliferative malignancies, 62% vs 12% in the lymphoproliferative group, and 55% vs 22% in benign disorders. Complications were encountered in 20% of all patients studied. This study shows that, for selected chest lesions, CT-guided cutting-needle biopsies can be performed safely and are useful, especially in the diagnosis of lymphoproliferative or benign disease.
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