Percutaneous Transthoracic Lung Biopsy

Abstract

Percutaneous transthoracic needle biopsy (TNB) has emerged as a viable and minimally invasive procedure for the diagnosis of indeterminate pulmonary nodules, masses, and consolidations. Over the past two decades with continued improvements in small gauge coaxial core needle systems and biopsy technique, coaxial core biopsy is now a preferred technique for pulmonary lesions as it can obtain larger specimens for diagnosis and molecular analysis. Core needle samples are becoming increasingly important as recent advances in molecular profiling require adequate tumor tissue to identify specific mutations allowing for targeted cancer therapy and for accurate prognosis. With the continued improvement in imaging technology, needle design, biopsy technique, enhanced targeting, and strategies for preventing and managing potential complications, previously inaccessible pulmonary lesions can be biopsied in a safe and reliable manner. This chapter gives an overview of TNB including its indications, contraindications, the imaging modalities currently used for guidance, and the special techniques utilized in performing the procedure and minimizing complications.