CT Guided Needle Biopsies of Intrathoracic Masses by Different Approaches

Purpose: To report our experience with computed tomography (CT)-guided coaxial needle biopsy of intrathoracic lesions by different approaches. Material methods: Medical records of 100 patients who underwent CT-guided biopsy of intrathoracic lesions were evaluated retrospectively. A coaxial needle technique was used in all patients; an 18-gauge needle was used for transsternal penetration, through which a 22-gauge needle was passed to obtain fine-needle aspirates. Five patients also underwent core-needle biopsy with a coaxially introduced 20-gauge needle. Medical records were reviewed for lesion size and location, needle path, number of needle penetrations, reasons for failure, biopsy results, and complications. Results: The transsternal approach was used in mediastinal (n = 32) or intrapulmonary (n = 5) lesions. Extrapleural access to the mediastinal lesions was achieved in all but one patient in whom the 22-gauge needle traversed the lung. Conclusion: The CT-guided coaxial core-needle biopsy allows safe access to masses in various locations in the thorax and anteromedial lung.