Full core technology versus notch sampling technology: evaluation of the diagnostic accuracy and the risk of a pneumothorax after transthoracic needle biopsy of suspicious lung lesions

Acta Radiol. 2022 Jan;63(1):35-41. doi: 10.1177/0284185120981575. Epub 2020 Dec 26.

Abstract

Background: Percutaneous needle biopsy of the lung (PCBL) under image guidance has become a safe and effective minimal invasive method to obtain a specimen related histological diagnosis of pulmonary lesions.

Purpose: To evaluate the diagnostic yield and safety of two different coaxial biopsy technologies: full core and notch sampling technology. The former allowing the removal of full punch cylinders and the latter using a cutting-edge mechanism.

Material and methods: A retrospective analysis of 48 consecutive PCBL procedures has been carried out for this prognostic study, involving patients with a documented pulmonary nodule or mass lesion on previous computed tomography (CT) scans. The study population included 38 men and 10 women (mean age = 67 years). Of these 48 patients who underwent a procedure with a co-axial cutting system, 24 have been performed with notch sampling technology and 24 with full core technology.

Results: Out of the 48 biopsy procedures, 46 yielded specimens were adequate for histopathological evaluation, consistent with a technical success rate of 96%. The most common induced image-guided biopsy complication was a pneumothorax, occurring in 14 patients (35%). Seven patients with a pneumothorax were attributed to the full core technology and seven to the notch sampling technology (odds ratio = 1, 95% confidence interval = 0.28-3.51, P = 1).

Conclusion: In the setting of full core versus notch sampling percutaneous CT-guided coaxial needle biopsy of the lung, no significant difference in the diagnostic accuracy and the incidence of pneumothoraces could be shown, while both technologies have an excellent diagnostic performance.

Keywords: Percutaneous lung biopsy; diagnostic accuracy; efficacy; full core technology; image guidance; notch sampling technology; pulmonary lesions; safety.

MeSH terms

  • Aged
  • Biopsy, Large-Core Needle / adverse effects
  • Female
  • Humans
  • Image-Guided Biopsy / adverse effects
  • Image-Guided Biopsy / methods*
  • Lung Diseases / diagnostic imaging
  • Lung Diseases / pathology*
  • Male
  • Pneumothorax / etiology*
  • Prognosis
  • Retrospective Studies
  • Tomography, X-Ray Computed*