Thoracic biopsy: CT guidance of thin-needle aspiration

CT-guided percutaneous thin-needle aspiration biopsy of 23 mediastinal and 27 other thoracic masses was performed in 40 patients over a 2-year period. Although biplane fluoroscopy is considered the optimal guidance mechanism for thoracic biopsy, CT was required in this group of patients to ensure accurate needle placement within the lesions or within the most appropriate subsegment of necrotic lesions. A specific diagnosis was obtained in 34 cases, an overall diagnostic accuracy of 85%. Although CT guidance allowed an extrapleural needle trajectory in 23 patients, five of the remaining 17 patients sustained a pneumothorax for which two required tube thoracotomy.