E4861. Outcomes of CT-Guided Percutaneous Transthoracic Needle Biopsy (PTNB) of Cavitary Pulmonary Nodules
  1. Abhay Dhaliwal; Corewell Health William Beaumont University Hospital
  2. Andrew Ragheb; Corewell Health William Beaumont University Hospital
  3. Nicolas Baker; Corewell Health William Beaumont University Hospital
  4. Rohun Gupta; SSM Health St. Louis University Hospital
  5. Sayf Al-Katib; Corewell Health William Beaumont University Hospital
  6. Monisha Shetty; Corewell Health William Beaumont University Hospital
  7. Kiran Nandalur; Corewell Health William Beaumont University Hospital
Many pulmonary disease processes, ranging from chronic infection to malignant neoplasms, can present with cavitary pulmonary nodules or masses. On imaging, there can be considerable overlap between benign and malignant cavitary lesions, which makes it difficult to assess malignancy status on imaging alone. The goal of this study is to evaluate the efficacy, feasibility, and rate of complications of percutaneous transthoracic needle biopsy (PTNB) of cavitary pulmonary lesions.

Materials and Methods:
A retrospective chart review was conducted of patients who underwent PTNB for cavitary pulmonary lesions at a single institution. Patients were included if they underwent a pulmonary biopsy between July 2014 to July 2021 by diagnostic or interventional radiologists. Biopsy reports, frequency of pneumothorax and chest tube utilization, and other relevant complications were collected. Descriptive statistics were then conducted to analyze the collected date.

There were 426 cases of PTNB isolated after chart review, and 61.5% (262/426) of biopsied pulmonary lesions were found to be malignant. The diagnostic rate was 92.7% (395/426), and the frequency of pneumothorax was found to be 21.1% (90/426). Chest tubes were placed in 5.2% (22/426) of biopsies.

Based on our data, we can conclude that PTNB is a safe, reliable, and efficacious diagnostic method with a low complication rate when used to assess cavitary pulmonary lesions. Our diagnostic rate and rate of pneumothorax is comparable to that of when PTNB is utilized for solitary pulmonary nodules, demonstrating that CT-guided percutaneous transthoracic needle biopsy for cavitary lesions is a feasible option in certain patient populations. Although a commonly performed procedure, improved planning and additional information regarding procedural risks may help decrease the rate of complications associated with PTNB.