Ipsilateral Dual-Site, Same-Sitting Percutaneous Lung Biopsy: A Feasibility Study

Area of Science:

• Pulmonology
• Thoracic Oncology
• Interventional Radiology

Background:

• Thoracic malignancies frequently present with multiple lesions within a single hemithorax.
• Large or heterogeneous lesions may represent distinct pathological entities.
• Accurate histological diagnosis is critical for staging and treatment planning.

Purpose of the Study:

• To evaluate the feasibility, safety, and clinical benefit of performing image-guided percutaneous lung biopsy (PLB) on two distinct lesions within the same hemithorax during a single outpatient procedure.

Main Methods:

• Ten outpatients with multiple thoracic lesions underwent CT-guided coaxial 20G core biopsy of two lesions in the same hemithorax.
• Separate punctures were used for each lesion.
• Patients were managed under an ambulatory lung biopsy protocol, with Heimlich-valve chest drains (HVCD) available for significant pneumothorax.

Main Results:

• 100% technical success was achieved, with informative histological diagnoses obtained for both lesions in all 10 patients (20 biopsies total).
• Management was altered in all cases based on the dual-site biopsy results.
• Pneumothorax occurred in 60% of patients, but only two required HVCD treatment; no other significant complications were noted.

Conclusions:

• Dual-site percutaneous lung biopsy is a safe and effective single-procedure technique for diagnosing patients with multiple thoracic lesions.
• This method yields valuable staging information, directly influencing patient management decisions.