CT-Guided Percutaneous Core Needle Biopsy of Small Pulmonary Nodules - (< 2cm) - How Efficient is it as a Diagnostic Tool in Ruling Out Metastatic Disease

Q: What was the primary aim of the CT-guided CNB study for small pulmonary nodules?

To report the diagnostic accuracy and complication rate of CT-guided transthoracic core biopsy for pulmonary nodules measuring less than 2 cm in long-axis diameter.

Q: How successful was the CT-guided percutaneous core needle biopsy in obtaining a pathologically reportable sample?

The success rate was 92.9% (157/169), defined as obtaining a pathologically reportable quality sample.

Q: Which factors were associated with pneumothorax, and how often did it require treatment?

Using a thicker (18G) biopsy needle was the only statistically significant predictor of pneumothorax (odds ratio 2.61; p=0.01). Pneumothorax occurred in 21.9% of cases (37/169), and only 5.3% (9/169) required treatment.

Sep 30, 2026

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CT-guided percutaneous core needle biopsy (CNB) is evaluated as a diagnostic tool for small pulmonary nodules (<2 cm), a technically challenging setting in patients with underlying malignancy where sampling is needed to exclude metastatic disease. A retrospective single-center study included 169 patients (Jan 2015–Dec 2018) who underwent CT-guided percutaneous CNB. Key outcomes were CNB success, diagnostic biopsy yield, and complication rates, with multivariate assessment of risk factors for pneumothorax and pulmonary hemorrhage.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Introduction

Materials and Methods

Results

Conclusion

Article published online: 2025-06-04 84 Original Article THIEME CT-Guided Percutaneous Core Needle Biopsy of Small Pulmonary Nodules ( < 2cm): How Efﬁcient is it as a Diagnostic Tool in Ruling Out Metastatic Disease? Dayananda Lingegowda 1 Manisha Agrawal 1 Argha Chatterjee 1 Priya Ghosh 1 Jeevitesh Khoda 1 Anisha Gehani 1 Saugata Sen 1 Sumit Mukhopadhyay 1 Aditi Chandra 1 Anurima Patra 1 1 Department of Radiology, Tata Medical Center, Kolkata, West Bengal, India Indian J Radiol Imaging 2026;36:84–91. Address for correspondence Dayananda Lingegowda, MBBS, DNB, Department of Radiology, Tata Medical Center, 14 Arterial Road, Newtown, Kolkata, West Bengal 700160, India (e-mail: [dayanandal@gmail.com](dayanandal@gmail.com)). Abstract Keywords ► CT-guided biopsy ► lung metastasis ► small pulmonary nodules Introduction Incidentally detected small pulmonary nodules in patients with an underlying malignancy most often warrant sampling. Biopsy from such small pulmonary nodules ( < 2 cm) is challenging. In this study, we aim to evaluate the accuracy of computed tomography (CT)-guided percutaneous core needle biopsy (CNB) of small pulmonary nodules. Materials and Methods A total of 169 patients who had CT-guided percutaneous CNB for small pulmonary nodules (less than 2 cm) between January 2015 and December 2018 were the subjects of this retrospective, single-center investigation. We determined the success rate of CNB and the rate of a diagnostic biopsy. Calculations were made for a multivariate study of the risk variables for complications, such as pneumothorax and pulmonary hemorrhage. Results The success rate of lung biopsy, deﬁned by obtaining a sample of pathologically reportable quality, was 92.9%(157/169). A malignancy was diagnosed in 60.4% of cases (102/169) . Pneumothorax developed in 21 .9% cases (37/169), with only 5.3%(9/169) patients requiring treatment (8 needle aspirations and 1 pigtail catheter drainage) . Use of a thicker (18G) biopsy needle was the only statistically signiﬁcant predictor of pneumothorax (odds ratio 2.61, 95% conﬁdence interval 1.24–5.51, p ¼ 0.01) . Perifocal hemorrhage was common (72.2%, 122/169) but clinically signiﬁcant pulmonary lobar hemorrhage was seen only in 6.5% of the cases (11/169) . One patient required intensive care unit admission due to desaturation from aspiration of blood. Conclusion CT-guided biopsy of small pulmonary nodules is safe and feasible with a good success rate. article published online June 4, 2025 DOI [https://doi.org/](https://doi.org/)[ ](https://doi.org/)10.1055/s-0045-1808259 . ISSN 0971-3026. © 2025 . Indian Radiological Association. All rights reserved. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by-nc-nd/4.0/](licenses/by-nc-nd/4.0/)) Thieme Medical and Scientiﬁc Publishers Pvt. Ltd. , A-12, 2nd Floor, Sector 2, Noida-201301 UP, India CT-Guided Percutaneous Core Needle Biopsy of Small Pulmonary Nodules Lingegowda et al. 85 Introduction Transthoracic biopsy plays an important role in the diagnosis and staging of primary lung cancer.1 Indeterminate lung nodules on imaging in patients with known malignancy need sampling to rule out any underlying metastatic foci, especially when curative options are considered.2,3 However, biopsy from lung lesions smaller than 2cm in size is a challenging task. In spite of availability of endobronchial biopsies (EBBs) and video-assisted thoracoscopic (VATS) biopsies, computed tomography (CT)-guided transthoracic biopsy remains the preferred method of choice for such smaller lesions.3 CT biopsy has advan

FAQs

What was the primary aim of the CT-guided CNB study for small pulmonary nodules?

To report the diagnostic accuracy and complication rate of CT-guided transthoracic core biopsy for pulmonary nodules measuring less than 2 cm in long-axis diameter.

How successful was the CT-guided percutaneous core needle biopsy in obtaining a pathologically reportable sample?

The success rate was 92.9% (157/169), defined as obtaining a pathologically reportable quality sample.

Which factors were associated with pneumothorax, and how often did it require treatment?

Using a thicker (18G) biopsy needle was the only statistically significant predictor of pneumothorax (odds ratio 2.61; p=0.01). Pneumothorax occurred in 21.9% of cases (37/169), and only 5.3% (9/169) required treatment.

Sep 30, 2026

Uploaded by moss~