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Review
. 2024 Dec 2;13(23):7330.
doi: 10.3390/jcm13237330.

CT-Guided Transthoracic Core-Needle Biopsy of Pulmonary Nodules: Current Practices, Efficacy, and Safety Considerations

Amalia Constantinescu  1 , Emil Robert Stoicescu  2   3   4   5 , Roxana Iacob  3   5   6 , Cosmin Alexandru Chira  1 , Daiana Marina Cocolea  1   5 , Alin Ciprian Nicola  1 , Roxana Mladin  1 , Cristian Oancea  7   8 , Diana Manolescu  2   7
Affiliations
Review

CT-Guided Transthoracic Core-Needle Biopsy of Pulmonary Nodules: Current Practices, Efficacy, and Safety Considerations

Amalia Constantinescu et al. J Clin Med. .

Abstract

CT-guided transthoracic core-needle biopsy (CT-TTNB) is a minimally invasive procedure that plays a crucial role in diagnosing pulmonary nodules. With high diagnostic yield and low complication rates, CT-TTNB is favored over traditional surgical biopsies, providing accuracy in detecting both malignant and benign conditions. This literature review aims to present a comprehensive overview of CT-TTNB, focusing on its indications, procedural techniques, diagnostic yield, and safety considerations. Studies published between 2013 and 2024 were systematically reviewed from PubMed, Web of Science, Scopus, and Cochrane Library using the SANRA methodology. The results highlight that CT-TTNB has a diagnostic yield of 85-95% and sensitivity rates for detecting malignancies between 92 and 97%. Several factors, including nodule size, lesion depth, needle passes, and imaging techniques, influence diagnostic success. Complications such as pneumothorax and pulmonary hemorrhage were noted, with incidence rates varying from 12 to 45% for pneumothorax and 4 to 27% for hemorrhage. Preventative strategies and management algorithms are essential for minimizing and addressing these risks. In conclusion, CT-TTNB remains a reliable and effective method for diagnosing pulmonary nodules, particularly in peripheral lung lesions. Advancements such as PET/CT fusion imaging, AI-assisted biopsy planning, and robotic systems further enhance precision and safety. This review emphasizes the importance of careful patient selection and procedural planning to maximize outcomes while minimizing risks, ensuring that CT-TTNB continues to be an indispensable tool in pulmonary diagnostics.

Keywords: CT-guided lung biopsy efficacy; CT-guided transthoracic biopsy; core-needle biopsy lung; lung biopsy safety; lung cancer diagnosis; minimally invasive lung biopsy; pneumothorax in lung biopsy; pulmonary hemorrhage biopsy; pulmonary nodule diagnosis; transthoracic biopsy complications.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart. Literature review.
Figure 2
Figure 2
Protocol algorithm for establishing nodule management before CT-guided TTNB.
Figure 3
Figure 3
Protocol algorithm for pre-procedural evaluation and medication management before CT- TTNB.
Figure 4
Figure 4
Protocol algorithm for the management of PNX after CT-guided TTNB.
See this image and copyright information in PMC

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