Our Summary

This research is about a procedure called percutaneous transthoracic needle biopsy (PTNB) which is used to diagnose lung nodules that are not fully solid (subsolid). The researchers looked at previous studies to see how accurate PTNB is at diagnosing these nodules and what complications might occur.

They found that PTNB can correctly identify whether a nodule is cancerous or not 90% of the time, and it can accurately rule out cancer 99% of the time. The procedure was slightly more accurate in patients over 65 years old. They also compared two types of needles used in the procedure and found that core needle biopsies were a little better at detecting cancer than fine-needle aspirations, but the difference was not significant.

The complication rate from the procedure was fairly high at 43%, but serious complications were very rare, occurring in only 0.1% of cases. The type of needle used did not affect the complication rate.

This is the first study to systematically explore the factors that can affect the accuracy and safety of PTNB for subsolid lung nodules.

FAQs

  1. What is a percutaneous transthoracic needle biopsy (PTNB) and what is it used for?
  2. How accurate is PTNB in diagnosing cancerous and non-cancerous lung nodules?
  3. What is the complication rate associated with PTNB, and does the type of needle used in the procedure impact this rate?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung biopsy is to follow all pre-procedure instructions provided by the healthcare team. This may include fasting before the procedure, stopping certain medications, and informing the medical team about any allergies or medical conditions. Following these instructions can help ensure a successful and safe biopsy procedure. Additionally, the doctor may advise the patient to ask any questions they have about the procedure and its risks beforehand, to ensure they are fully informed and prepared.

Suitable For

Patients who are typically recommended for lung biopsy include those with suspicious lung nodules or masses that are detected on imaging studies such as chest X-rays or CT scans. These nodules may be found incidentally or may be causing symptoms such as coughing, chest pain, or difficulty breathing. Patients with a history of smoking, a family history of lung cancer, or other risk factors for lung cancer may also be recommended for a lung biopsy. Additionally, patients with a history of other lung diseases such as pulmonary fibrosis or sarcoidosis may undergo a lung biopsy to help diagnose or monitor their condition.

Timeline

Before the lung biopsy:

  • Patient undergoes a CT scan to identify the presence of lung nodules
  • Patient may undergo other diagnostic tests such as a PET scan or bronchoscopy to further evaluate the nodules
  • Patient meets with a healthcare team to discuss the risks and benefits of the biopsy procedure
  • Patient may need to stop taking certain medications before the procedure
  • Patient may need to fast before the procedure

During the lung biopsy:

  • Patient is positioned on their side or back on a table
  • Local anesthesia is administered to numb the area where the biopsy will be performed
  • A needle is inserted through the skin into the lung nodule to collect a tissue sample
  • Patient may need to hold their breath for a few seconds during the biopsy
  • The tissue sample is sent to a lab for analysis

After the lung biopsy:

  • Patient may experience some pain or discomfort at the biopsy site
  • Patient may have some minor bleeding or bruising at the biopsy site
  • Patient is monitored for any signs of complications such as pneumothorax (collapsed lung)
  • Patient may need to stay in the hospital for a few hours or overnight for observation
  • Results of the biopsy are typically available within a few days to a week
  • Patient follows up with their healthcare team to discuss the biopsy results and next steps in their treatment plan

What to Ask Your Doctor

Some questions a patient should ask their doctor about lung biopsy include:

  1. What is the purpose of the biopsy and what information will it provide about my lung nodules?
  2. What are the risks and potential complications associated with the biopsy procedure?
  3. How accurate is the percutaneous transthoracic needle biopsy (PTNB) in diagnosing subsolid lung nodules?
  4. Is there a difference in accuracy between core needle biopsies and fine-needle aspirations for diagnosing cancer in subsolid lung nodules?
  5. Are there any factors, such as age, that may affect the accuracy of the biopsy results?
  6. What can I expect during and after the biopsy procedure?
  7. How should I prepare for the biopsy, including any necessary fasting or medication adjustments?
  8. How long will it take to receive the biopsy results?
  9. What are my treatment options depending on the biopsy results?
  10. Are there any alternative diagnostic procedures or tests that could be considered in place of or in addition to the biopsy?

Reference

Authors: Kim J, Chee CG, Cho J, Kim Y, Yoon MA. Journal: Br J Radiol. 2021 Nov 1;94(1127):20210065. doi: 10.1259/bjr.20210065. Epub 2021 Oct 18. PMID: 34662206