Computed tomography-guided core needle biopsy for lung nodules: low-dose versus standard-dose protocols

Area of Science:

• Radiology
• Pulmonology
• Interventional Radiology

Background:

• Computed tomography (CT)-guided core needle biopsy (CNB) is crucial for diagnosing lung nodules (LNs).
• Low-dose CT (LDCT) guided CNB aims to minimize radiation exposure compared to standard-dose CT (SDCT).

Purpose of the Study:

• To compare the technical success, safety, diagnostic yield, and radiation dose of LDCT-guided CNB versus SDCT-guided CNB for lung nodules.

Main Methods:

• Retrospective, single-center study including patients who underwent LDCT-guided or SDCT-guided CNB for LNs between January 2015 and December 2017.
• Collected data included technical success, diagnostic performance (yield, sensitivity, specificity, accuracy), complications (pneumothorax, hemorrhage), and radiation exposure (dose-length product).

Main Results:

• Both LDCT and SDCT groups achieved 100% technical success.
• Diagnostic performance metrics (yield, sensitivity, specificity, accuracy) were comparable between LDCT and SDCT groups (e.g., diagnostic yield: 71.4% vs. 67.7%, p=0.637).
• Mean dose-length product was significantly lower in the LDCT group (38.3 mGy·cm) compared to the SDCT group (376.0 mGy·cm, p < 0.001). Complication rates were similar.

Conclusions:

• LDCT-guided CNB is a safe and effective alternative to SDCT-guided CNB for lung nodules.
• LDCT-guided CNB provides comparable diagnostic performance while substantially reducing patient radiation exposure.