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Evidence-based Approach to Transthoracic Needle Biopsy: Procedural Techniques, Risks, and Controversies.

Shravan Sridhar¹, Hannah G Ahn¹, Sayedomid Ebrahimzadeh¹

¹From the Department of Radiology and Biomedical Imaging, University of California-San Francisco, 505 Parnassus Ave, M-391 Box 0628, San Francisco, CA 94143.

Radiographics : a Review Publication of the Radiological Society of North America, Inc

|August 28, 2025

Summary

This summary is machine-generated.

Transthoracic needle biopsy (TTNB) is a crucial diagnostic tool for malignancy and infection. Evidence supports its use, including for molecular testing, when safe and feasible, optimizing patient care.

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Area of Science:

Radiology
Interventional Radiology
Diagnostic Imaging

Background:

Transthoracic needle biopsy (TTNB) is a standard diagnostic procedure.
It plays a key role in evaluating suspected malignancy and infection.
Recent literature emphasizes best practices and new applications like molecular testing.

Purpose of the Study:

To review and support best practices in TTNB.
To highlight emerging uses of TTNB, such as molecular testing.
To guide radiologists in optimizing procedural outcomes and patient care.

Main Methods:

Literature review and synthesis of evidence.
Analysis of best practices in preprocedural evaluation, technique, and risk mitigation.
Discussion of current controversies and emerging applications.

Main Results:

TTNB is a valuable tool for various clinical questions.
Molecular testing is an emerging and important application of TTNB.
An evidence-based approach enhances procedural outcomes.

Conclusions:

TTNB should be considered when technically feasible and safe.
Radiologists should maintain an evidence-based approach to TTNB.
Optimizing TTNB practices supports multidisciplinary patient care.