Computed tomography-guided biopsy for sub-centimetre pulmonary nodules: a meta-analysis

Area of Science:

• Pulmonology
• Radiology
• Interventional Oncology

Background:

• Sub-centimetre pulmonary nodules (≤ 10 mm) pose diagnostic challenges due to their small size.
• These nodules have significant malignancy rates (47.5-61.5%), necessitating accurate diagnosis.
• Computed tomography (CT)-guided biopsy is technically difficult for these small lesions.

Purpose of the Study:

• To evaluate the safety and diagnostic utility of CT-guided biopsy for sub-centimetre pulmonary nodules.
• To pool data from existing studies to assess key procedural endpoints.

Main Methods:

• A meta-analysis of studies published up to April 2023 from PubMed, Web of Science, and Wanfang databases.
• Pooled analysis of technical success, diagnostic yield, diagnostic accuracy, pulmonary hemorrhage, and pneumothorax rates.
• Comparison of diagnostic accuracy between fine-needle and core-needle biopsy approaches.

Main Results:

• The meta-analysis included 10 studies with 1482 patients.
• Pooled rates: 90% technical success, 60% diagnostic yield, 91% diagnostic accuracy, 11% pulmonary hemorrhage, 24% pneumothorax.
• Core-needle biopsy showed higher diagnostic accuracy (95%) than fine-needle biopsy (85%).

Conclusions:

• CT-guided biopsy is a safe and effective procedure for the accurate diagnosis of sub-centimetre pulmonary nodules.
• The technique offers a high diagnostic yield and accuracy, despite the small size of the nodules.
• Core-needle biopsy may offer improved diagnostic accuracy compared to fine-needle biopsy.