COMPUTERIZED TOMOGRAPHY (CT) GUIDED BIOPSY OF LUNG LESIONS: INDICATIONS, YIELD AND COMPLICATIONS.

Abstract

Background: Computerized tomography (CT) guided percutaneous lung biopsy is a minimally invasive method to obtain tissue samples for histopathology and sometimes microbiologic analysis from pulmonary lesions and/or masses suspected to represent malignancy or refractory infection. Genetic testing (molecular profiling) can be performed on samples for certain types of cancers to help to identify gene mutations that can be targeted during therapy.

0bjectives: To study the type of lung lesions on which CT-guided biopsy is done in our settings, diagnostic yield and complications of the procedure.

Participants: Patients with lung lesions undergone  CT-guided percutaneous lung biopsy.

Material & Methods:  This was an observational (retrospective and prospective study). Total number of 159 patients who underwent CT-guided percutaneous lung biopsy were taken for study out of which 46 patients were retrospectively taken and the data concerning the patients who were studied retrospectively was collected from medical charts and files using hospital’s medical record documentation (MRD) service. Information regarding the rest of 113 patients who were prospectively studied, included patient who were planned for CT-guided biopsy were admitted to hospital (internal and pulmonary medicine ward).

Results: In this study we found that most common indication of CT-guided percutaneous biopsy were lung lesions suspicious of malignancy comprised of 81 of total 159 patients (50.9%), second most common indication was non-resolving lung consolidation (21.4%).Overall diagnosis was achieved in 148 patients in our study with diagnostic yield of (93.1%).Total of 48 patients (30.2%) developed complication due the procedure, out of which most common complication was Pneumothorax in around 34 (21.4%) of patients. COPD & Depth of lesion from pleural surface were predominant risk factors for occurrence of complication.

Conclusion: CT-guided biopsy of lung lesion is very accurate and precise tool to achieve specific diagnosis with high diagnostic yield & very low rate of high-risk complication, most of the complication can be managed conservatively. Best lesions in which the CT-guided biopsy should be planned are peripheral lung lesions. Better then bronchoscopy in terms of diagnostic yield.