CT-guided automated cutting needle biopsy by a combined method for accurate specific diagnosis of focal lung lesions

PURPOSE: The purpose of our study was to evaluate a method of automated cutting needle biopsy (ACNB) that combines the use of a long-throw needle, higher mean number of needle passes, and tandem system, in terms of the accuracy of specific diagnosis of small and large lung lesions and the safety of the procedure. MATERIALS AND METHODS: Fifty-seven ACNBs were performed under computed tomography guidance using a tandem system with a 20-gauge and 18-gauge (through non-aerated lung) automated cutting needle with a throw length of 23 mm. We classified the nodules into 21 small nodules (< or =2 cm) and 36 large nodules (>2 cm). All ACNB diagnoses were divided into three groups: specific, non-specific, and false diagnoses. All of the complications were recorded. RESULTS: The mean number of ACNB specimens obtained was 2.0. Of the 35 ACNB procedures for malignant lesions, 33 yielded a specific malignant diagnosis (33/35, 94%). Of the 22 procedures for benign lesions, 17 gave a specific benign diagnosis (17/22, 77%). The diagnostic accuracy for small nodules was no lower than that for large nodules. Postbiopsy pneumothorax occurred in 18 patients (32%). CONCLUSION: The diagnostic accuracy of the combined method is as high for small lung nodules as for large ones. The procedure has high diagnostic accuracy for the subtypes of lung cancer and an acceptable complication rate.