Computed tomography-guided core needle biopsy for lung nodules: low-dose versus standard-dose protocols.

Abstract

IntroductionComputed tomography (CT)-guided core needle biopsy (CNB) is an essential step in the management of lung nodules (LNs). Low-dose CT (LDCT)-guided CNB has been used to decrease the radiation exposure.AimTo evaluate the technical success, safety, diagnostic capacity, and radiation exposure to patients between LDCT-guided and standard-dose CT (SDCT)-guided CNB for LNs.Material and methodsThis is a retrospective, single-centre study. Patients who underwent LDCT-guided or SDCT-guided CNB for LNs from January 2015 to December 2017 were included. Data on technical success, diagnostic performance, complications, and radiation exposure were collected and analysed.ResultsA total of 70 and 65 patients underwent LDCT-guided and SDCT-guided CNB procedure, respectively. The technical success rates were 100% in both groups. The diagnostic yield, sensitivity, specificity, and overall diagnostic accuracy in the LDCT and SDCT groups were 71.4% and 67.7% (p = 0.637), 97.8% and 93.2% (p = 0.625), 100%, and 100%, and 98.6% and 95.4% (p = 0.560), respectively. The independent risk factor of diagnostic failure was less sample tissues (p = 0.012; 95% confidence interval: 0.033–0.651). Pneumothorax was found in 9 and 12 patients in the LDCT and SDCT groups, respectively (p = 0.369). Lung haemorrhage was found in 11 and 12 patients in the LDCT and SDCT groups, respectively (p = 0.671). The mean dose-length product was 38.3 ±17.0 mGy · cm and 376.0 ±118.7 mGy · cm in the LDCT and SDCT groups, respectively (p < 0.001).ConclusionsCompared to SDCT, LDCT-guided CNB can provide comparable safety and diagnostic performance for LNs while reducing exposure to radiation.