Comparison of computed tomography–guided core needle biopsy of pulmonary nodules performed with and without the coaxial technique

TL;DR

This study compares two methods for lung nodule biopsies and finds that one method is faster and more efficient without increasing risks.

Contribution

The study provides new evidence on the procedural efficiency and diagnostic yield of CT-guided core needle biopsy with and without the coaxial technique.

Findings

CT-guided CNB with CAT had fewer needle pathways, shorter duration, and higher diagnostic yield.

Diagnostic accuracy was similar between CAT and non-CAT groups.

Complication rates like pneumothorax and pulmonary hemorrhage were not significantly different.

Abstract

Computed tomography (CT)-guided core needle biopsy (CNB) is a common method for diagnosing pulmonary nodules (PNs). It is often performed using the coaxial technique (CAT) to streamline the process.

This study aimed to compare the safety and diagnostic performance of CT-guided CNB with and without CAT for diagnosing PNs.

This retrospective analysis included patients undergoing CT-guided CNB for a diagnosis of PNs between January 2017 and December 2019. The study population was divided according to the use of CAT for the biopsy. Procedure-related data, diagnostic accuracy and yield, and complication rates were compared between the 2 groups.

During the study period, a total of 111 and 108 patients underwent CT-guided CNB with and without CAT, respectively. As compared with the non-CAT group, the CAT group showed a lower mean needle pathway number (P <⁠0.001), a higher mean sample number (P <⁠0.001), and shorter procedural duration (P <⁠0.001). Diagnostic accuracy was similar between the 2 groups (98.3% vs 96.3%, respectively, for CAT vs non-CAT; P = 0.6), though the CAT group demonstrated a higher diagnostic yield than the non-CAT group (81.4% vs 68.5%; P = 0.03). Pneumothorax and pulmonary hemorrhage rates did not differ between the 2 groups (P = 0.09 and P = 0.16, respectively).

CT-guided CNB with CAT demonstrated greater procedural efficiency, with fewer needle pathways, shorter operative duration, and improved diagnostic yield, as compared with procedures performed without CAT.

Figures