Percutaneous needle biopsy for small lung nodules beneath the rib under CT scan fluoroscopic guidance with gantry tilt.

Abstract

OBJECTIVES: The present study was performed to evaluate the efficacy and safety of gantry tilting for the performance of lung biopsy of peripheral small lesions located beneath the rib. DESIGN: Interventional. MATERIALS AND METHODS: Our study was based on 22 of 237 lesions for which percutaneous needle biopsies of the lung were performed under CT scan-fluoroscopic guidance at our institution between January 2000 and August 2002. For these 22 lesions, a biopsy was performed with gantry tilt because a rib blocked the biopsy route even after trials to change the relationship between the target and the rib. The characteristics of each lesion, the success rate for obtaining an adequate specimen, and the ability to determine whether the lesion was malignant or benign were investigated, specific cell types were characterized, and the complications that were encountered were identified. RESULTS: In all 22 lesions, adequate specimens for cytopathologic evaluation were obtained using fine-needle aspiration biopsy, tissue core biopsies, or both. In 21 lesions, whether the lesion was malignant or benign was precisely diagnosed, and in 19 lesions the specific cell type was determined. No serious complications occurred. CONCLUSION: Percutaneous needle biopsy under CT scan-fluoroscopic guidance with gantry tilt is a useful and safe technique for the biopsy of small lung nodules located beneath the rib.