Results and complications of percutaneous co-axial trans-thoracic biopsy in lung masses: our clinical experience

Aims: The aim of our study was to evaluate the diagnostic rates and procedure-related complications in lung masses undergoing computed tomography (CT)-guided percutaneous coaxial trans-thoracic biopsy (PCTTB). Methods: We retrospectively analyzed 117 patients who underwent CT-guided PCTTB between January 2016 and December 2018. A 64 slice Multislice-CT was used in each patient. A core biopsy was performed with a 16–18-gauge needle using the co-axial method. The demographic characteristics of the patients, post-procedural diagnosis rates, and complications were evaluated. Results: Of 117 patients, 93 were male (mean age 67.9±10.8 years) and 24 were female (mean age 64.2±15.2 years). The pathologic evaluation of three patients was reported as "insufficient material". The diagnostic sensitivity of CT-guided PCTTB was 97.4%. Malignant lesions were detected in 70 patients (59.8%) and benign lesions in 44 patients (37.9%). The most common complication was pneumothorax, which occurred in 24 (20.5%) patients. A thoracic tube was inserted in three of these patients, while the others were discharged with follow-up. Other complications were hemorrhage (10.3%) and hemoptysis (12%), respectively. While mortality in CT-guided biopsy was associated with air embolization in some studies, mortality was not present in our study. Conclusion: CT-guided PCTTB lung biopsies have a high diagnostic rate and acceptable complications. Percutaneous coaxial trans-thoracic biopsy should be the first choice in all appropriate cases.