Ultrasound-guided percutaneous needle aspiration biopsy of peripheral pulmonary lesions

Percutaneous needle aspiration (PCNA) biopsy of pulmonary lesions is usually performed under fluoroscopic or computed tomographic guidance. In subpleural lesions, PCNA may be performed under ultrasonographic guidance. In this study, the diagnostic results of ultrasound-guided PCNA in 45 patients with peripheral pulmonary lesions of unknown aetiology are evaluated. The overall diagnostic yield was 80% (36/45). The most important factor affecting the success rate was the nature of the lesion. The diagnostic yield was 92% (33/36) in malignant lesions, but only 33% (3/9) in benign lesions. The size of the lesions did not affect the success rate. None of the patients had complications. Ultrasound-guided PCNA is a quick cheap ionizing radiation-free procedure and may be a valid option in the diagnosis of peripheral lesions. The real-time monitoring, possibility of driving the needle into solid nonnecrotic areas and visualization of the vessels surrounding the lesions make the procedure effective and safe. The major limitation of the method is that the nodule from which a biopsy is to be taken must be close to the visceral pleura, and thus detectable by ultrasound.