CT-guided aspiration biopsy of the thorax

Percutaneous needle aspiration biopsy of thoracic lesions was performed under the guidance of computed tomography (CT) in 28 patients. The lesions chosen for CT guidance of needle placement were those not amenable to demonstration by biplane fluoroscopy: lesions in or adjacent to the mediastinum or hila; peripheral lesions; and small or ill-defined lesions, such as cavitary masses. The accuracy of the technique was assessed on the basis of pathological and radiographic confirmation of the cytologic diagnoses. The sensitivity of the technique was 84% (16/19), the specificity was 100% (6/6), and the overall accuracy was 88% (22/25). Inadequate specimens were obtained in two patients, and another patient could not complete the procedure. Pneumothorax, which developed in 17 patients, was remedied by intercostal tube drainage in three. There was one mild episode of hemoptysis, which resolved spontaneously. We recommended that CT-guided aspiration biopsy of thoracic lesions be used when the type, size, or position of the lesion makes fluoroscopic guidance of the needle unreliable.