RESULTS AND SAFETY OF COMPUTED TOMOGRAPHY GUIDED TRANSTHORACIC BIOPSY FOR SOLITARY PULMONARY NODULE

Abstract

In this study of 72 patients with solitary pulmonary nodules who underwent CT-guided transthoracic core needle biopsy at Bach Mai Hospital, most patients were older adults with a high prevalence of comorbidities, and 43.1% of nodules were incidentally detected. Solid, upper-lobe nodules with spiculated margins were the predominant radiological features, and most lesions fell into the intermediate-risk category according to the Brock Model. CT-guided biopsy demonstrated excellent diagnostic performance, with a specimen acquisition rate of 98.6% on the first attempt and 100% in repeated procedures. Malignancy accounted for 55.6% of nodules—primarily adenocarcinoma—while 44.4% were benign, including chronic inflammatory lesions and tuberculosis. Several factors showed significant associations with malignant etiology, including older age, spiculated borders, presence of emphysema, larger nodule size (≥20 mm), and Brock risk ≥10%. The procedure exhibited a favorable safety profile: pneumothorax occurred in 26.1% of biopsy sessions, though only 4.3% required chest tube drainage, and hemoptysis was mild and self-limited in all cases. No severe complications or deaths were recorded. Overall, CT-guided transthoracic core needle biopsy proved to be a safe, accurate, and effective diagnostic modality for solitary pulmonary nodules in our clinical setting.