Journals / Abant Tıp Dergisi / 2026 / Cilt: 15 Sayı: 2

Safety and Outcomes of Image-Guided Transthoracic Lung Biopsy: Experience from a Single-Center Cohort Study

Samet Genez(BOLU ABANT İZZET BAYSAL ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0002-1484-4496
Hamza Özer(BOLU ABANT İZZET BAYSAL ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0003-3210-4544
Ayşenur Buz Yaşar(BOLU ABANT İZZET BAYSAL ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0003-1324-2810
Yunus Yılmazsoy(BOLU ABANT İZZET BAYSAL ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0001-7293-2059
Samet Deniz(BOLU ABANT İZZET BAYSAL ÜNİVERSİTESİ, TIP FAKÜLTESİ)0009-0008-8159-1880
Pages
121–129
Publication Date
2026-08-28
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Careful pre-procedural planning and experienced operator technique are critical to optimizing outcomes and minimizing risks.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: Transthoracic needle biopsy (TTNB) under image guidance is a cornerstone technique for the diagnosis of pulmonary lesions.
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Key Findings & Data:This study aimed to evaluate the safety, diagnostic yield, and complication profile of image-guided TTNB and to identify lesion-related factors influencing adverse outcomes.
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Conclusion & Impact:Careful pre-procedural planning and experienced operator technique are critical to optimizing outcomes and minimizing risks.
🔬Design:Araştırma Makalesi
📍Scope:2023 Verileri
⚙️Variables:Transthoracic Lung Biopsy · Computed Tomography · Pneumothorax

Abstract

Objective: Transthoracic needle biopsy (TTNB) under image guidance is a cornerstone technique for the diagnosis of pulmonary lesions. Despite its high diagnostic accuracy, procedure-related complications remain a concern. This study aimed to evaluate the safety, diagnostic yield, and complication profile of image-guided TTNB and to identify lesion-related factors influencing adverse outcomes. Materials and Methods: This single-center retrospective cohort study included 184 consecutive patients (143 males, 41 females; median age, 65 years) who underwent image-guided TTNB between January 2023 and May 2025. Most procedures (98.9%) were CT-guided, and a coaxial 17 G/18 G core needle technique was consistently used. Lesion characteristics, procedural parameters, and complications were recorded. Statistical analysis was performed to assess associations between lesion depth, size, and complication occurrence. Results: The diagnostic yield was 94.1%, with nondiagnostic samples in 5.9% of cases. Histopathological results revealed adenocarcinoma (29.3%), squamous cell carcinoma (12.5%), small-cell carcinoma (4.3%), metastatic tumors (4.9%), and benign lesions (17.4%). Pneumothorax occurred in 27.7% of patients, requiring drainage in 4.3%. Minor alveolar hemorrhage was observed in 16.3%, and one patient (0.5%) experienced a fatal air embolism. Complication rates were significantly associated with greater lesion depth (p = 0.0000632) and smaller lesion size (p = 0.001704), while emphysema showed no significant correlation (p = 0.3928). Conclusion: Image-guided TTNB using a coaxial 17 G/18 G technique demonstrates high diagnostic accuracy and an acceptable safety profile. Lesion depth and size are key predictors of procedural complications. Careful pre-procedural planning and experienced operator technique are critical to optimizing outcomes and minimizing risks.

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Cite This Article

Genez, S., Özer, H., Yaşar, A. B., Yılmazsoy, Y., Deniz, S. (2026). Safety and Outcomes of Image-Guided Transthoracic Lung Biopsy: Experience from a Single-Center Cohort Study. Abant Tıp Dergisi, Cilt: 15 Sayı: 2, 121–129. https://doi.org/10.47493/abantmedj.1798058

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References (25)

  1. Li C, Lei S, Ding L, et al. Global burden and trends of lung cancer incidence and mortality. Chin Med J (Engl). 2023;136(13):1583-90.
  2. Chung C, Kim Y, Park D. Transthoracic needle biopsy: How to maximize diagnostic accuracy and minimize complications. Tuberc Respir Dis (Seoul). 2020;83(Suppl 1):S17-24.
  3. Constantinescu A, Stoicescu ER, Iacob R, et al. CT-guided transthoracic core-needle biopsy of pulmonary nodules: current practices, efficacy, and safety considerations. J Clin Med. 2024;13(23):7330.
  4. Schulze R, Seebacher G, Enderes B, et al. Complications in CT-guided, semi-automatic coaxial core biopsy of potentially malignant pulmonary lesions. Rofo. 2015;187(8):697-702.
  5. Rizzo S, Preda L, Raimondi S, et al. Risk factors for complications of CT-guided lung biopsies. Radiol Med. 2011;116(4):548-63.
  6. Wu CC, Maher MM, Shepard JA. Complications of CT-guided percutaneous needle biopsy of the chest: prevention and management. AJR Am J Roentgenol. 2011;196(6):W678-82.
  7. Yeow KM, Su IH, Pan KT, et al. Risk factors of pneumothorax and bleeding: multivariate analysis of 660 CT-guided coaxial cutting needle lung biopsies. Chest. 2004;126(3):748-54.
  8. Tomiyama N, Yasuhara Y, Nakajima Y, et al. CT-guided needle biopsy of lung lesions: a survey of severe complication based on 9783 biopsies in Japan. Eur J Radiol. 2006;59(1):60-4.
  9. Görgülü FF, Öksüzler FY, Arslan SA, et al. Computed tomography-guided transthoracic biopsy: factors influencing diagnostic and complication rates. J Int Med Res. 2017;45(2):808-15.
  10. Baratella E, Cernic S, Minelli P, et al. Accuracy of CT-guided core-needle biopsy in diagnosis of thoracic lesions suspicious for primitive malignancy of the lung: a five-year retrospective analysis. Tomography. 2022;8(6):2828-38.
  11. Choi SH, Chae EJ, Kim JE, et al. Percutaneous CT-guided aspiration and core biopsy of pulmonary nodules smaller than 1 cm: analysis of outcomes of 305 procedures from a tertiary referral center. AJR Am J Roentgenol. 2013;201(5):964-70.
  12. Borelli C, Vergara D, Simeone A, et al. CT-guided transthoracic biopsy of pulmonary lesions: diagnostic versus nondiagnostic results. Diagnostics (Basel). 2022;12(2):359.
  13. De Margerie-Mellon C, De Bazelaire C, De Kerviler E. Image-guided biopsy in primary lung cancer: why, when and how. Diagn Interv Imaging. 2016;97(10):965-72.
  14. Marhana IA, Widianiti K, Kusumastuti EH. Conformity of fine needle aspiration biopsy (FNAB) and core needle biopsy (CNB) in peripheral lung tumor patients: a cross-sectional study. Ann Med Surg (Lond). 2022;75:103423.
  15. Gardner D, vanSonnenberg E, D’Agostino HB, et al. CT-guided transthoracic needle biopsy. Cardiovasc Intervent Radiol. 1991;14(1):17-23.
  16. Shen M, Chen H, Shu J, et al. The association between core number and complications in ultrasound-guided percutaneous lung core needle biopsy for subpleural primary lung cancer: a retrospective study. BMC Pulm Med. 2025;25(1):38.
  17. Gupta S, Wallace MJ, Cardella JF, et al. Quality improvement guidelines for percutaneous needle biopsy. J Vasc Interv Radiol. 2010;21(7):969-75.
  18. Yoon SH, Park CM, Lee KH, et al. Analysis of complications of percutaneous transthoracic needle biopsy using CT-guidance modalities in a multicenter cohort of 10568 biopsies. Korean J Radiol. 2019;20(2):323-31.
  19. DiBardino DM, Yarmus LB, Semaan RW. Transthoracic needle biopsy of the lung. J Thorac Dis. 2015;7(Suppl 4):S304-16.
  20. Khan MF, Straub R, Moghaddam SR, et al. Variables affecting the risk of pneumothorax and intrapulmonal hemorrhage in CT-guided transthoracic biopsy. Eur Radiol. 2008;18(7):1356-63.
  21. Schneider F, Smith MA, Lane MC, et al. Adequacy of core needle biopsy specimens and fine-needle aspirates for molecular testing of lung adenocarcinomas. Am J Clin Pathol. 2015;143(2):193-200.
  22. Jiang B, Takashima S, Miyake C, et al. Thin-section CT findings in peripheral lung cancer of 3 cm or smaller: are there any characteristic features for predicting tumor histology or do they depend only on tumor size? Acta Radiol. 2014;55(3):302-8.
  23. Gupta S, Krishnamurthy S, Broemeling LD, et al. Small (≤2-cm) subpleural pulmonary lesions: short- versus long-needle-path CT-guided biopsy--comparison of diagnostic yields and complications. Radiology. 2005;234(2):631-7.
  24. Li Y, Yang CF, Peng J, et al. Small (≤20 mm) ground-glass opacity pulmonary lesions: which factors influence the diagnostic accuracy of CT-guided percutaneous core needle biopsy? BMC Pulm Med. 2022;22(1):258.
  25. Ruud EA, Stavem K, Geitung JT, et al. Predictors of pneumothorax and chest drainage after percutaneous CT-guided lung biopsy: a prospective study. Eur Radiol. 2021;31(6):4243-52.