低剂量技术降低CT引导下经皮肺切割活检吸收剂量的临床研究

目的 探讨临床应用低剂量技术降低CT引导下经皮肺穿刺自动切割活检(ACNB)辐射剂量的可行性。方法 412例ACNB中146例(A组)采用传统方法引导,266例(B组)采用低剂量技术引导,按图像颗粒均匀性、解剖结构细节、界面清晰度和有无伪影等评定图像质量,比较2组穿刺活检准确率、操作时间及辐射剂量,并探讨CT引导中降低辐射剂量的方法。结果 B组图像解剖结构细节分辨率降低,但不影响穿刺成功率。A、B组穿刺准确率分别为95.9%、95.1%,操作时间为(16±2.2)、(15.9±2.0)min,组间差异均无统计学意义。A、B组有效剂量为(1.74±0.7)及(0.59±0.14)mSv,B组有效剂量降低66%,差异有统计学意义(t=19.3415,P(0.05)。结论 CT引导下经皮肺穿刺活检是诊断和鉴别肺部病变的重要方法,低剂量扫描、缩小扫描范围及减少扫描次数能显著降低受检者X线辐射剂量,但不影响诊断效果。     

CT-guided percutaneous lung biopsy using a cutting needle and an automated biopsy gun. Comparison with lung biopsy using a manual aspiration needle]

Twenty-five percutaneous lung biopsies using a 20-gauge cutting needle and automated biopsy gun (ABG) were performed under CT guidance in 25 patients with thoracic lesions. This procedure was compared with that using a 21-gauge manual aspiration needle in 36 patients (40 examinations, 37 lesions) in terms of success rate, rate of correct diagnosis, mean examination time and rate of complications. Specimens obtained from lung biopsy were graded by a histopathologist according to quality and quantity from 0 to 4 (pathological score). There were no statistically significant differences between the two procedures in terms of success rate, rate of correct diagnosis and rate of complications; only the time required was significantly different. However, sufficient biopsy material and a mean pathological score of G-II 2.8 (that of G-I was 1.9, p less than 0.05) could be obtained by the biopsy procedure using the cutting needle. The above results indicated that aspiration needle biopsy was adequate for lung biopsy, but that a cutting needle and ABG should be used when a good biopsy specimen is needed for tissue diagnosis.     

CT-guided cutting needle biopsy of lung lesions--an effective procedure for adequate material and specific diagnose

Objective

Computed guided percutaneous biopsy of lung lesions is widely accepted as an effective and safe procedure for specific diagnose. The purpose of this study is to present the experience of an oncology center in the use of computed tomography (CT)-guided cutting needle biopsy as an effective procedure for adequate material and specific diagnose of lung lesions.

Subjects and methods

This study reports a retrospective analysis of 94 consecutive patients admitted in an oncologic center, reference in Brazil (Hospital do Câncer—AC Camargo), between 1996 and 2004, who were submitted to 97 CT guided cutting needle biopsy of pulmonary lesions. Informations of material adequacy and specific diagnose were studied.

Results

In a total of 97 biopsies of lung lesions, 94 (96.9%) supplied adequate material for histological analyses with 71 (73.2%) as malignant lesions and 23 (23.7%) diagnosed as benign lesions and in 3 biopsies the material supplied was inadequate. The frequency of specific diagnosis was higher in both malignant and benign lesions with 63 (88.7%) cases and 20 (86.7%) cases respectively.

Conclusions

CT-guided cutting needle biopsy is an effective procedure for adequate material and specific diagnostic for malignant and benign lung lesions.     

Diagnostic accuracy of CT-guided automated needle biopsy of lung nodules

OBJECTIVE: The purpose of this study was to determine the factors influencing diagnostic accuracy in CT-guided automated needle biopsies of lung nodules. SUBJECTS AND METHODS: One hundred thirty-eight consecutive CT-guided automated needle biopsy procedures were performed in 123 patients (124 pulmonary nodules). Factors for diagnostic accuracy were evaluated through analysis of the procedures, which were classified into a success group (true-positive and true-negative) and a failure group (false-positive and false-negative). RESULTS: Final diagnoses were 81 malignant lesions (91 biopsies) and 43 benign lesions (47 biopsies). More than two CT-guided biopsies were performed for 13 lesions. Seventy lesions were true-positive, 44 were true-negative, three were false-positive, and 21 were false-negative. The overall diagnostic accuracy was 82.6%. The sensitivity for malignancy and specificity for benign lesions were 76.9% and 93.6%, respectively. Positive and negative predictive values were 95.9% and 67.7%, respectively. Lesion size was a significant factor contributing to diagnostic accuracy (p = 0.014). Mean diameters of lesions (+/-SD) in the success and failure groups were 24.1+/-12.4 mm and 17.6+/-7.8 mm, respectively. For lesions 6-10 mm in diameter, diagnostic accuracy was 66.7%; for lesions 11-20 mm in diameter, 78.9%; for lesions 21-30 mm in diameter, 86.7%; for lesions 31-50 mm in diameter, 93.3%; and for lesions 51-70 mm in diameter, 100%. CONCLUSION: Lesion size was a determining factor in diagnostic accuracy. Diagnostic accuracy decreased in proportion to the decrease in the lesion diameter.     

Risk factors for pneumothorax and bleeding after CT-guided percutaneous coaxial cutting needle biopsy of lung lesions.

PURPOSE: To evaluate risk factors for pneumothorax and bleeding after computed tomography (CT)-guided percutaneous coaxial cutting needle biopsy of lung lesions. MATERIALS AND METHODS: This study involved 117 consecutive patients with 117 intrapulmonary lesions. Statistical analysis of factors related to patient characteristics, lung lesions, and biopsy technique was performed to determine possible contribution to the occurrence of pneumothorax and bleeding. Interactions between related factors were considered to prevent colinearity. RESULTS: Pneumothorax occurred in 12% (14 of 117) of patients. Needle aspiration of two moderate asymptomatic pneumothoraces were performed; there was no chest tube insertion. Lesion depth (P =.0097), measured from the pleural puncture site to the edge of the intrapulmonary lesion along the needle path, was the single significant predictor of pneumothorax. The highest risk of pneumothorax occurred in subpleural lesions 2 cm or shorter in depth (this represented 33% of lung lesions but caused 71% of all pneumothoraces; OR = 7.1; 95% CI, 1.3-50.8). Bleeding presented as lung parenchyma hemorrhage and hemoptysis in 30 patients (26%). Hemoptysis occurred in four patients (3%). Univariate analysis identified lesion depth (P <.0001), lesion size (P <.015), and pathology type (P =.007) as risk factors for bleeding. Multivariate logistic regression analysis identified lesion depth as the most important risk factor, with the highest bleeding risk for lesions more than 2 cm deep (14% of lesions caused 46% of all bleeding; OR = 17.3; 95% CI, 3.3-121.4). CONCLUSIONS: In CT-guided coaxial cutting needle biopsy, lesion depth is the single predictor for risk of pneumothorax, which occurs at the highest rate in subpleural lesions. Increased risk of bleeding occurs in lesions deeper than 2 cm.     

经皮肺活检对肺部病变的临床诊断意义

目的 评价经皮肺活检术对原发性肺癌、肺转移性癌以及非恶性肺疾病的诊断价值.方法 回顾性总结近10年来436例经皮肺活检患者的临床资料,其中明确为原发性肺癌患者341例、肺转移性癌62例、非恶性肺疾病33例.统汁分析经皮肺活检术对上述疾病的诊断准确率及灵敏度.结'果原发性肺癌组经皮肺活检阳性321例,诊断准确率为94.7%、灵敏度94.1%;肺转移性癌组阳性32例,诊断准确率58.2%、灵敏度51.6%;非恶性肺疾病组阳性19例,诊断准确率以及灵敏度均为57.6%.436例患者中427例经皮肺活检获得足够病变组织标本,9例活检失败,活检成功率97.9%.全部患者共穿刺474例次,其中74例次出现并发症,发生率15.6%.主要并发症有气胸(63例次,13.3%)和肺内出血(56例次,11.8%).结论 临床上怀疑原发性肺癌的肺部病变,经皮肺活检术诊断准确率高,并发症少且轻微.对于考虑为肺转移性癌以及非恶性肺疾病,该技术尚有待进一步改进.     

螺旋CT引导下自动切割针系统在肺活检中的应用价值

目的 研究螺旋CT引导下，采用自动可分离切割针系统经皮穿刺活检的诊断价值。方法 螺旋CT引导，使用自动弹射活检枪、16G～21G可调式同轴切割针，对287例肺内结节性病灶行经皮穿刺肺活检。结果 262例获定性诊断，其中恶性病变195例，良性病变67例，定性诊断率为91.3％，气胸、咯血等轻微并发症为21.3％。结论 螺旋CT引导下自动可分离切割针系统是一种安全、准确、有效的肺球形病灶检查方法，值得临床推广。     

CT-guided transthoracic needle biopsy of pulmonary lesions: comparison between the cutting needle and aspiration needle

Objectives:To compare CT-guided transthoracic cutting needle biopsy (TCNB) with transthoracic aspiration needle biopsy (TANB) for pulmonary lesions with respect to the diagnostic accuracy and complication rate.Methods:Of the 859 cases that underwent consecutive CT-guided biopsy of pulmonary lesions, 713 cases confirmed by surgical pathology or clinical follow-up were enrolled. Of these, the first consecutive 275 cases underwent TANB, and the remaining 438 received TCNB. The final diagnosis determined the accuracy of biopsy. Based on the post-biopsy CT and clinical medical records, the presence or absence of biopsy-related complications was determined. The χ² test was used to compare the differences between TCNB and TANB in terms of diagnostic accuracy and complication rate.Results:Among the 713 biopsy lesions, the final diagnosis was malignant in 411 cases and benign in 302 cases. As compared to TANB, the diagnostic accuracy of TCNB (98.9% vs 93.8%, χ² = 14.35, p < 0.01), sensitivity to malignant lesions (97.8% vs 90.6%, χ² = 10.58, p < 0.01), negative predictive value (97.6% vs 84.8%, χ² = 19.03, p < 0.01), and specific diagnostic rate for benign lesions (73.4% vs 57.9%, χ² = 7.29, p < 0.01) were improved. On the other hand, a statistical difference was detected between TCNB and TANB with respect to the incidence of pneumothorax (20.6% vs 13.1%, χ² = 6.46, p = 0.01), hemorrhage (32.2% vs 13.1%, χ² = 33.03, p < 0.01), and hemoptysis (8.2% vs 3.3%, χ² = 6.87, p < 0.01). One patient died just several minutes after TCNB due to severe hemorrhage with hemoptysis.Conclusions:Compared to TANB, CT-guided TCNB improves the diagnostic accuracy of pulmonary lesions, but complication rate increases significantly.Advances in knowledge:In general, TCNB should be recommended, especially for highly suspicious benign lesions. For patients with small lesions adjacent to vessels or vessels within the lesion, TANB should be considered.     

CT fluoroscopy-guided cutting needle biopsy of focal pure ground-glass opacity lung lesions: diagnostic yield in 83 lesions

Objective

The objective of our study was to retrospectively determine the diagnostic yield of CT fluoroscopy-guided cutting needle biopsy of focal pure ground-glass opacity lung lesions.

Materials and methods

Biopsies were performed using 20-G coaxial cutting needles for 83 focal pure ground-glass opacity lung lesions (mean lesion size, 12.1 mm). After excluding the lesions for which biopsy specimens were unobtainable and final diagnoses were undetermined, the diagnostic yield, including sensitivity and specificity for a diagnosis of malignancy and accuracy, was calculated. The lesions were then divided into 2 groups: the diagnostic failure group, comprising lesions with false-negative results and for which a biopsy specimen was unobtainable; and the diagnostic success group, comprising lesions with true-negative results and true-positive results. Various variables were compared between the 2 groups by univariate analysis.

Results

Biopsy specimens were obtained from 82 lesions, while specimens could not be obtained from 1 lesion. Final diagnosis was undetermined in 16 lesions. The sensitivity and specificity for a diagnosis of malignancy were 95% (58/61) and 100% (5/5), respectively. Diagnostic accuracy was 95% (63/66). The 4 lesions in diagnostic failure group were smaller, deeper, and more likely to be located in the lower lobe and further, for those lesions, number of specimens obtained was smaller, compared with 63 lesions in diagnostic success group. However, none of the differences were statistically significant.

Conclusion

CT fluoroscopy-guided cutting needle biopsy provided high diagnostic yield for focal pure ground-glass opacity lung lesions.     

CT-guided transthoracic cutting needle biopsy of intrathoracic lesions: comparison between coaxial and single needle technique

Purpose

To evaluate the complication rates and diagnostic accuracy of two different CT-guided transthoracic cutting needle biopsy techniques: coaxial method and single needle method.

Methods

This study involved 198 consecutive subjects with 198 intrathoracic lesions. The first 98 consecutive subjects received a single needle cutting technique and the next 100 consecutive subjects received a coaxial technique. Both groups were compared in relation the diagnostic accuracy and complication rates.

Results

No significant difference was found between the two groups concerning patient characteristics, lesions and procedure variables. There was a borderline statistical difference in the incidence of pneumothorax at within 24-h post biopsy between patients in the single needle group (5%) and the coaxial group (13%) (P = 0.053). Little difference was found in the pneumothorax rate at immediately post biopsy between the two groups, which was 28% in the single needle group and 31% in the coaxial group. There was no significant difference in the hemoptysis rate between the two groups, which was 9.2% in the single needle group and 11% in the coaxial group. Both techniques yielded an overall diagnostic accuracy of 98% for malignant lesions with similar sensitivity (single needle: 96.9% vs. coaxial: 96.4%) and specificity (single needle: 100% vs. coaxial: 100%).

Conclusion

There is little difference in the pneumothorax rates and bleeding complications between patients who either received a single needle or a coaxial transthoracic cutting biopsy. Both techniques produce an overall diagnostic accuracy of 98% for malignant lesions.     

CT-guided cutting needle biopsy of lung lesions--safety and efficacy of an out-patient service

AIM: To determine the safety and efficacy of CT-guided cutting needle biopsy of lung lesions as an out-patient procedure. MATERIALS AND METHODS:A total of 185 consecutive biopsies were performed under CT guidance on 183 patients between January 1991 and December 1998 using 20-gauge (n= 33), 18-gauge (n= 151) or 14-gauge (n= 1) core biopsy needles. A chest radiograph was taken after observation in the Radiology department for 1 h and asymptomatic patients were discharged. RESULTS: The histology was malignant in 150 biopsies (81. 1%) and benign in 23 (12.4%) with 12 false-negative results (6.5%); there were no false-positive results. The sensitivity was 92.6%; specificity 100%; negative predictive value 65.7%; and overall accuracy 93.5%. Pneumothoraces occurred in 48 patients (25.9%); one required aspiration only and four required insertion of an intercostal drain. One patient developed a pneumothorax after discharge. Small haemoptyses occurred in 13 patients without pneumothorax (7.0%), one of whom was admitted. In-patient treatment was required in 10 patients (5.4%). CONCLUSION: Computed tomography-guided cutting needle biopsy of pulmonary lesions is a safe technique with a diagnostic accuracy and complication rate comparable to reported figures for fine needle aspiration biopsy. It can be safely performed on an out-patient basis.     

CT-guided core needle biopsy in the diagnosis of pancreatic diseases with an automated biopsy gun

PURPOSE: To evaluate the safety and diagnostic accuracy of computed tomographic (CT)-guided core needle biopsy (CNB) in the diagnosis of pancreatic diseases by using an automated biopsy gun with a cutting-type needle. MATERIALS AND METHODS: From January 2000 to January 2006, CT-guided CNB was performed in 80 patients suspected of having pancreatic diseases in the absence of liver metastasis. Biopsies were performed with an 18-20-gauge cutting needle driven by a spring-loaded biopsy gun. Histologic reports and medical records of all patients were retrospectively reviewed. An institutional review board exemption was obtained to perform this retrospective study. RESULTS: All patients tolerated the biopsies well, with no serious complications. Three patients had mild abdominal pain after the procedure, and a limited abdominal CT scan did not reveal any marked abnormality. Two patients had an elevated serum amylase level, which returned to normal within 2 weeks. A definitive diagnosis and accurate histologic diagnosis were obtained for 69 patients, for a successful diagnosis rate of 86%. Surgical sampling was performed in 11 patients with neoplasms and nondiagnostic core-needle biopsies. Only 50% of patients with well-differentiated adenocarcinomas were definitely diagnosed with CT-guided CNB. CONCLUSIONS: CT-guided CNB with an automated biopsy gun is a safe and effective method for obtaining tissue for the histologic evaluation of pancreatic diseases. However, CT-guided CNB requires further development for the accurate diagnosis of well-differentiated adenocarcinomas.     

CT引导下经皮切割肺活检对弥漫性肺疾病的诊断价值

目的评价经皮切割肺活检术对弥漫性肺疾病的诊断价值及安全性。方法采用自动弹簧式活检枪（14及16G）对29例弥漫性肺疾病患者在CT引导下行经皮切割肺活检,所获组织送病理组织学及免疫组化检查。并对取材成功率、诊断阳性率以及并发症等进行分析。结果29例患者均获得足够行病理检查的肺组织标本,取材成功率达到100％。有25例获得确诊,诊断阳性率达82．8％。并发症主要为气胸以及肺出血,大多数不严重,且经相应治疗后均在1周内消失。结论对于弥漫性肺疾病,CT引导下经皮切割肺活检术无论在手术操作、取材成功率以及诊断阳性率均优于经支气管肺活检（TBLB）。与开胸肺活检（OLB）和电视引导下胸腔镜肺活检（VATS）相比,并发症少且轻微,患者接受度高。该技术值得推广。     

Diagnostic accuracy of CT-guided percutaneous cutting needle biopsy for thymic tumours

AIM: To determine the diagnostic accuracy of computed tomography (CT)-guided percutaneous cutting needle biopsy (PCNB) for thymic tumours in accordance with the World Health Organization (WHO) classification. MATERIAL AND METHODS: We retrospectively analysed a consecutive series of 138 cases in which CT-guided PCNB had been performed for an anterior mediastinal tumour. Its sensitivity and specificity for thymic epithelial tumours were evaluated, and the concordance between the histopathological diagnosis according to the WHO classification of thymic tumours based on PCNB and the diagnosis is based on the surgical specimens was assessed by Kappa statistic. RESULTS: The diagnostic sensitivity and specificity of CT-guided PCNB for thymic tumours were 93.3 and 100%, respectively. The overall concordance between the diagnosis according to the WHO classification established by PCNB specimen and by the surgical specimen was 79.4% (weighted kappa=0.79). CONCLUSION: CT-guided PCNB is a reliable method of diagnosing thymic tumours, and there was good concordance for the WHO classification between the diagnosis based on CT-guided PCNB specimen and that based on the surgical specimen.     

Systemic air embolism after CT-guided transthoracic biopsy using a cutting needle

The authors report a case of systemic air embolism after CT-guided transthoracic needle biopsy using an 18G cutting needle. CT performed immediately after the occurrence of neurological signs showed air within the left ventricle but no air within the cerebral arteries. Radiologists must be aware of this extremely rare but potentially severe complication to provide accurate diagnosis and treatment.     

CT引导下经皮肺穿刺活检对周围型肺部病变的诊断价值

目的探讨CT引导下经皮肺穿刺活检对周围型肺部病变的诊断价值及其安全性。方法对58例周围型肺部病变的患者,在CT引导下行经皮肺穿刺活检。结果 58例患者中穿刺标本经组织病理学检查确诊病例48例,确诊率为82.8%,其中恶性肿瘤32例,良性病变16例。术后出现有症状并发症7例,其中咯血2例,气胸4例,高热伴脓胸1例,总发生率为12.1%。结论 CT引导下经皮肺穿刺活检定位准确,成功率高,安全可靠,在周围型肺部病变诊断中具有较高的应用价值。     

CT-guided aspiration core needle biopsy of gastrointestinal wall lesions

PURPOSE: The purpose of this work was to examine the accuracy and safety of CT-guided core biopsy of gastrointestinal wall lesions. METHOD: We reviewed over 1,200 CT-guided abdominal core biopsy results from 1989 through 1998. Forty-five were from gastrointestinal wall lesions (16 gastric, 3 duodenal, 7 small intestine, and 19 colon). RESULTS: A definitive histologic diagnosis was obtained from the core biopsy in 41 patients (91%) without complication. The gastric lesion diagnoses were mesenchymal tumor of smooth muscle origin (eight), lymphoma (one), adenocarcinoma (three), and normal (one). Duodenal core biopsy diagnoses were inflammation (one) and normal (one). Small intestinal core biopsy diagnoses were non-Hodgkin lymphoma (four), metastatic leiomyosarcoma (one), carcinoma (one), and tuberculosis (one). Colon core biopsy diagnoses were carcinoma (11), lymphoma (2), actinomycosis (2), granulomatous inflammation (1), metastatic squamous cell carcinoma (1), chronic abscess (1), and mesenchymal tumor of smooth muscle origin (1). CONCLUSION: Percutaneous CT-guided core needle biopsy from gastrointestinal wall lesions is safe and accurate, especially in submucosal lesions, and should be considered in selected cases with negative endoscopic biopsy or in which endoscopic biopsy is not possible.     

CT-guided cutting needle lung biopsy using modified coaxial technique: factors effecting risk of complications

Purpose

We present our 7-year experience with coaxial computed tomography (CT)-guided cutting needle lung biopsy and evaluate the factors affecting risk of complications.

Material and method

Between June 2000 and March 2007, we performed 225 CT-guided coaxial lung biopsies in 213 consecutive patients (161 men, 52 women). Lesion size, lesion depth, lesion location, needle-pleural angle, presence of pleural effusion, patient's position, and complications secondary to biopsy procedure (pneumothorax and bleeding) were noted. Pneumothorax was graded as mild, moderate, and severe. Bleeding complications were graded as mild, moderate, and severe.

Results

Two hundred twenty-five biopsy procedures were performed in 213 patients. The mean diameter of the lung lesion was 41.3 ± 20.1 mm. The mean distance from the peripheral margin of the lesion to the pleura was 17.3 ± 19.2 mm. After 225 procedures, there were 42 mild (18.6%), 13 moderate (5.7%), and 4 severe (1.7%) pneumothoraxes. Small hemoptysis occurred in 27 patients (12%), and mild parenchymal hemorrhage occurred in 2 patients (0.8%). The overall complication rate was 39.1%. Although, a statistically significant correlation was found between female sex, presence of emphysema, lesion depth, and pneumothorax, none of these factors had a predictive value for pneumothorax. Although, statistically significant correlations were found between female sex, lesion size, and bleeding, only lesion size had a predictive value for bleeding.

Conclusion

The most frequent and important complications of this procedure are pneumothorax and bleeding. But any factor is the predictor of pneumothorax and lesion depth is a poor predictor of bleeding complication.     

Accuracy of CT-guided transthoracic needle biopsy of lung lesions: Factors affecting diagnostic yield

PURPOSE: This study was performed to analyse the variables affecting the diagnostic accuracy of computed tomography (CT)-guided transthoracic needle biopsy of pulmonary lesions. MATERIALS AND METHODS: A retrospective study of 612 consecutive procedures with confirmed final diagnoses was undertaken. Benign and malignant needle biopsy results were compared with final outcomes to determine diagnostic accuracy. A statistical analysis of factors related to patient characteristics, lung lesions and biopsy technique was performed to determine possible influences on diagnostic yield. A p value less than 0.05 was interpreted as statistically significant. RESULTS: There were 508 (83%) malignant and 104 (17%) benign lesions. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy for a diagnosis of malignancy were 90.2%, 99.0%, 99.8%, 67.3% and 91.7%, respectively. Overall diagnostic accuracy was 83.3%. Variables affecting diagnostic accuracy were the final diagnosis (benign 67%, malignant 92%; p<0.001) and lesion size (lesions<1.5 cm 68%, lesions 1.5-5.0 cm 87%, lesions>5 cm 78%; p<0.05). CONCLUSIONS: In CT-guided transthoracic needle biopsy, the final diagnosis and lesion size affect diagnostic accuracy: benign lung lesions and lesions smaller than 1.5 cm or larger than 5.0 cm in diameter provide lower diagnostic yield.     

Percutaneous CT-guided multisampling core needle biopsy of thoracic lesions

OBJECTIVE: The purpose of our study was to evaluate the diagnostic yield and the complication rate of percutaneous CT-guided coaxial 18-gauge (1.25-mm diameter) multisampling (five samples) core needle biopsy (CNB) of suspected thoracic lesions. MATERIALS AND METHODS: The records of 75 consecutive patients (29 women, 46 men; age range, 33-92 years) who underwent percutaneous CT-guided adjustable coaxial 18-gauge multisampling (five samples) CNB of a suspected thoracic lesion (eight mediastinal lesions, two chest wall lesions, two pleural lesions, and 63 intrapulmonary lesions) were reviewed. RESULTS: Ninety-seven percent (73/75) of CNB specimens were considered adequate for a specific diagnosis by the histopathology staff. Diagnostic yield was 97% (95% confidence interval, 91-99%) (72/74) (number of correct diagnoses obtained at CNB / number of definitive diagnoses). There were 61 malignant lesions and 11 benign lesions. There was no false-negative result when CNB was considered adequate for a specific diagnosis by the histopathology staff. Pneumothorax occurred in 19% (12/63 intrapulmonary lesions). One patient required placement of a chest tube. Minor postbiopsy hemoptysis occurred and resolved spontaneously in 11% (7/63) of patients. CONCLUSION: Percutaneous CT-guided coaxial multisampling large CNB of suspected thoracic lesions, in a mainly cancer-based population, is an accurate procedure for a specific histologic diagnosis and has a low rate of complications.