Laser positioning versus conventional CT-Guided lung biopsy: A systematic review and meta-analysis of clinical...

CT-guided percutaneous lung biopsy remains essential for diagnosing pulmonary nodules but is frequently complicated by pneumothorax, hemorrhage, and hemoptysis. Laser-assisted CT-guided biopsy (LACT) has been proposed to enhance procedural precision and safety. This meta-analysis compared the efficacy and safety of LACT versus conventional CT-guided (CCT) lung biopsies.

A comprehensive search of six electronic databases was performed to identify studies comparing LACT and CCT lung biopsies. Statistical analyses were performed using RevMan 5.4.1, and P < 0.05 was considered statistically significant. Meta-regression was done by Open Meta-Analyst.

Twelve studies involving 1353 patients were included. The LACT group demonstrated significantly higher first-puncture success (RR = 2.47, 95 % CI: 1.44-4.23, P = 00.001), fewer CT scans and needle adjustments (MD = -1.50, 95 % CI: -2.08 to -0.91, P < 0.00001), shorter procedure duration (MD = -7.69 min, 95 % CI: -9.75 to -5.64, P < 0.00001), and shorter intraoperative time (P < 0.00001). LACT also showed a lower overall complication rate, including pneumothorax, hemorrhage, and hemoptysis. Meta-regression indicated that increasing age was associated with a higher pneumothorax risk.

LACT-guided lung biopsy improves first-puncture success, procedural efficiency, and safety compared with the conventional approach. However, as most studies originated from a single geographic region and had variable methodological quality, these findings require confirmation through larger, multicenter randomized controlled trials.

LACT may offer procedural and safety advantages over conventional CT-guided lung biopsy, with the potential to reduce risks to patients. Future considerations include the need for robust, generalizable evidence beyond the studied population and geographic setting, along with support for wider clinical implementation such as standardized device specifications, workflow and protocol optimization, professional-body guidance, and operator training.