Synchronous Percutaneous Biopsy and Cryoablation for Suspicious Solitary Pulmonary Nodules

To evaluate the feasibility, diagnostic yield, and safety of synchronous CT-guided core needle biopsy and cryoablation for highly suspicious 1-2 cm pulmonary nodules MATERIALS AND METHODS: This retrospective single-center study included 102 consecutive patients undergoing synchronous CT-guided core needle biopsy and cryoablation between August 2020 and October 2025. Treatment was undertaken on the basis of clinical and imaging suspicion before final histopathologic diagnosis. A cryoprobe was placed before biopsy to provide an intraprocedural landmark. Technical success, diagnostic yield, and adverse events were evaluated in all 102 patients; local tumor progression and overall survival were evaluated separately in 81 patients with pathology-confirmed NSCLC.

Cryoablation technical success was 100% (102/102), and concurrent biopsy diagnostic yield was 87.3% (89/102). Biopsy identified 86 malignant diagnoses, including 81 NSCLCs. Mean nodule diameter was 1.52 ± 0.30 cm. Median follow-up in the NSCLC cohort was 34.5 months (IQR, 18.4-49.4 months). The cumulative incidence of recorded local tumor progression was 8.8% at both 1 and 3 years, and overall survival was 100% and 90.8%, respectively. Pneumothorax requiring chest tube drainage occurred in 20.6% (21/102), and no procedure-related deaths were reported.

The synchronous biopsy and cryoablation approach was technically feasible and provided a specific histopathologic diagnosis in 87.3% of selected patients with highly suspicious 1.0-2.0-cm pulmonary nodules. Among patients with pathology-confirmed NSCLC, local-control outcomes were within the range reported in similar cryoablation-only series.