Transthoracic needle biopsy with a coaxially placed 20-gauge automated cutting needle: Results in 122 patients

PURPOSE: To determine the utility of coaxial transthoracic needle biopsy (TNB) with use of a 20-gauge automated cutting biopsy needle in the diagnosis of thoracic lesions. MATERIALS AND METHODS: A retrospective review was performed in 122 patients. Computed tomography was used to guide coaxial TNB, which was performed with aspirating (n = 87) and automated cutting (n = 99) needles. The sensitivities for malignant and benign lesions were determined, with a comparison of the relative yields from the two techniques. RESULTS: The overall diagnostic yield for coaxial TNB was 88%. For malignancy the sensitivity was 95%, whereas a specific benign diagnosis was obtained in 91%. Although no difference was found for fine-needle aspiration versus core biopsy of malignant lesions (92% vs 86%), a statistically significant difference was found for benign lesions (44% vs 100%, P <.05). Pneumothorax occurred in 54%. CONCLUSION Coaxial TNB performed with an automated cutting needle helps provide a diagnosis in the majority of patients with focal chest disease and is particularly useful in the diagnosis of benign lesions.