Avoidance of negative percutaneous lung biopsy using contrast-enhanced CT

Area of Science:

• Pulmonary Medicine
• Radiology
• Oncology

Background:

• Fluoroscopically guided percutaneous biopsy is a standard procedure for pulmonary masses.
• Large neoplasms can present diagnostic challenges due to necrotic areas.
• Multiple biopsies may be required, increasing patient risk and healthcare costs.

Observation:

• Prebiopsy contrast-enhanced computed tomography (CT) can identify viable tumor tissue.
• This technique selectively demonstrates peripherally located, viable neoplastic tissue.
• Three cases illustrate the successful use of contrast-enhanced CT in challenging biopsies.

Findings:

• Contrast-enhanced CT accurately localized viable tissue in initially frustrated lung biopsies.
• This imaging modality guided aspiration to diagnostically relevant areas.
• Successful diagnosis was achieved after initial biopsy failures.

Implications:

• Contrast-enhanced CT can improve the diagnostic yield of percutaneous lung biopsies.
• This approach may reduce the need for repeat procedures and associated complications.
• Enhanced imaging guidance can lead to more efficient diagnosis of pulmonary neoplasms.