Transthoracic needle biopsy in differential diagnostics of peripheral lung tumors

Purpose. To determine indications and effectiveness of transthoracic biopsy of peripheral lung lesions under roentgenoscopy and CT-control. Material and methods. 57 patients with single or multiple peripheral lung lesions underwent transthoracic biopsy. Among them 76% of diagnostic procedures were performed under roentgenoscopy and 24% under CT-control. Diameter of peripheral lung lesions varied from 4 to 123 mm (mean 33,7 mm). Results. General effectiveness of all transthoracic biopsies was 90% (86% and 95% for roentgenoscopy and CT-control, P=0,16). For small lesions (less than 20 mm) CT-control appeared to be more effective (66,7% and 42,9% for CT-control and roentgenoscopy respectively), but for large lesions (more than 20 mm) the effectiveness of the two methods was similar (95,5% and 88,9% for CT-control and roentgenoscopy respectively). Complications frequency was 16% and 24% for roentgenoscopy and CT-control. Cytological (as the result of transthoracic biopsy) and pathological (as the result of surgery) diagnoses matched in 90%. Conclusions. Transthoracic biopsy under roentgenoscopy is a modern and effective method of peripheral lung lesions differential diagnosis because it provides real-time control, less radiation dose for patient, less working time for medical personnel and is highly competitive with CT-controle.