MRI-guided percutaneous coaxial cutting needle biopsy of small pulmonary nodules: feasibility

Abstract

Objectives: To prospectively evaluate the feasibility, safety and accuracy of magnetic resonance imaging (MRI)-guided percutaneous coaxial cutting needle biopsy of small (≤2.0 cm in diameter) pulmonary nodules.

Methods: Ninety-six patients (56 men and 40 women) with 96 small lung nodules underwent MRI-guided percutaneous coaxial cutting needle biopsy. These lesions were divided into two groups according to maximum nodule diameters: 0.5-1.0 cm (n = 25) and 1.1-2.0 cm (n = 71). The diagnostic accuracy, sensitivity and specificity were calculated, and comparison of the two groups was performed using Fisher's exact test.

Results: All specimens obtained were sufficient for diagnosis. Histological examination of needle biopsy revealed 64 malignant, 30 benign and 2 indeterminate nodules. The final diagnoses from surgery or clinical follow-up were 67 malignant nodules and 29 benign nodules. The diagnostic performance of MRI-guided percutaneous coaxial cutting needle biopsy in diagnosing malignant tumours was as follows: accuracy, 97 %; sensitivity, 96 %; specificity, 100 %; positive predictive value, 100 %; and negative predictive value, 91 %. There was no significant difference between the two groups (P > 0.05, Fisher's exact test). No serious complications occurred.

Conclusions: MRI-guided percutaneous coaxial cutting needle biopsy is a safe and accurate diagnostic technique in the evaluation of small lung nodules.

Key points: • MRI-guided biopsy helps clinicians to assess patients with small lung nodules. • Differentiation of malignant and benign nodules is possible with 97 % accuracy. • MRI guidance enables accurate lung biopsy without ionising radiation. • No serious complications occurred in MRI-guided lung biopsy.