CT-Guided Percutaneous Biopsy Techniques for Pulmonary Lesions

Computed tomography (CT)-guided percutaneous biopsy has become a cornerstone in the diagnosis of focal pulmonary abnormalities, offering minimally invasive access to lung nodules and masses. The technique employs real-time cross-sectional imaging to guide a needle through the chest wall and lung parenchyma to the target lesion. Two principal needle types are used: fine-needle aspiration (FNA) and core-needle biopsy (CNB), the latter often deployed via a coaxial needle system that permits multiple specimen passes through a single pleural puncture. Advances in imaging resolution, needle design and patient positioning have enhanced diagnostic yield while mitigating complications such as pneumothorax, haemorrhage and air embolism. Recent developments include integration of procedural radiomics to predict adverse events, the introduction of novel tract sealants to reduce post-procedural air leaks, and robotic assistance to improve needle steering in deep or difficult to reach lesions. CT-guided biopsy remains globally significant, informing therapeutic decisions in oncology, infectious disease and interstitial lung disorders, and continues to evolve through cross-disciplinary innovation in materials science, image analysis and interventional technique.

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CT-Guided Percutaneous Biopsy Techniques for Pulmonary Lesions publication trend

The graph below shows the total number of articles in ct-guided percutaneous biopsy techniques for pulmonary lesions across all publications each year (not limited to Nature Index journals).

Technical terms

Percutaneous biopsy: A minimally invasive procedure in which a needle is introduced through the skin into an internal organ or lesion under imaging guidance to obtain tissue.

Coaxial needle system: A two-stage needle assembly in which an outer introducer sheath remains in place to allow multiple passes of an inner biopsy needle without repeated pleural puncture.

Fine-needle aspiration (FNA): A technique using a thin (typically 20–25 gauge) needle to aspirate cellular material for cytological analysis.

Core-needle biopsy (CNB): A technique employing a larger (typically 14–18 gauge) cutting needle to retrieve a cylindrical tissue sample for histopathological examination.

Radiomics: The extraction and analysis of high-dimensional quantitative features from medical images to characterise tissue heterogeneity and predict clinical outcomes.

Pneumothorax: The presence of air in the pleural space, often a procedure-related complication of lung biopsy that may require chest-tube drainage.

References

1. Flexible Biopsy Robot with Force Sensing for Deep Lung Examination. Advanced Intelligent Systems (2023).
2. Swellable and Thermally Responsive Hydrogel/Shape Memory Polymer Foam Composites for Sealing Lung Biopsy Tracts. ACS Biomaterials Science & Engineering (2023).
3. Impact of radiomics features, pulmonary emphysema score and muscle mass on the rate of pneumothorax and chest tube insertion in CT-guided lung biopsies. Respiratory Research (2024).
4. Comparison between percutaneous transthoracic co-axial needle CT-guided biopsy and transbronchial lung biopsy for the diagnosis of persistent pulmonary consolidation. Insights into Imaging (2023).
5. Complication rates of CT-guided transthoracic lung biopsy: meta-analysis. European Radiology (2016).