Computed tomography-guided core needle biopsy for sub-centimeter pulmonary nodules

Area of Science:

• Pulmonology
• Radiology
• Oncology

Background:

• Sub-centimeter pulmonary nodules (SCPNs) are frequently detected during computed tomography (CT) screening.
• Approximately 15% of screened individuals have SCPNs, with 48-56% associated with lung cancer.
• Accurate diagnosis of SCPNs is crucial for timely lung cancer management.

Purpose of the Study:

• To evaluate the safety and diagnostic precision of CT-guided core needle biopsy (CNB) for SCPNs.
• To compare the diagnostic performance and complication rates of CNB for SCPNs versus larger pulmonary nodules (11-20 mm).

Main Methods:

• A retrospective study comparing CT-guided CNB in two groups: Group A (SCPNs, ≤10 mm) and Group B (larger nodules, 11-20 mm).
• Data collected included technical success rates, diagnostic yield, accuracy, sensitivity, and complication rates (pneumothorax, pulmonary hemorrhage).
• Statistical analysis was performed to compare outcomes between the groups and identify risk factors for diagnostic failure and complications.

Main Results:

• Technical success rates for CT-guided CNB were 100% in both groups.
• No significant differences were found in diagnostic yield, overall accuracy, or sensitivity between SCPNs and larger nodules.
• CNB-related pneumothorax was an independent risk factor for diagnostic failure; however, pneumothorax and pulmonary hemorrhage rates did not differ significantly between groups.

Conclusions:

• CT-guided CNB is a safe, reliable, and precise diagnostic method for SCPNs.
• The procedure demonstrates comparable efficacy and safety to that of larger pulmonary nodules.
• Risk factors for complications include decubitus position and multiple needle pathways for pneumothorax, and lesion-pleura distance for hemorrhage.