Computed tomography-guided biopsy for sub-centimeter lung nodules: technical success and diagnostic accuracy.

Introduction The differentiation of benign and malignant sub-centimetre (<= 10 mm) lung nodules (SCLNs) is challenging. Computed tomography (CT)-guided biopsy has been widely used for the diagnosis of lung nodules or masses. However, studies regarding CT-guided biopsies for SCLNs are still lacking. Objectives To evaluate the feasibility and diagnostic accuracy of CT-guided biopsies for SCLNs. Methods From December 2011 to October 2017, 102 patients with SCLNs underwent CT-guided lung biopsies. Data on technical success, diagnostic performance and procedure-related complications were collected and analysed. Results The technical success rate of CT-guided biopsy for SCLNs was 99% (101/102). One patient failed to undergo the procedure. A total of 101 SCLNs in 101 patients were examined. The biopsy diagnostic results included 38 malignant cases, 1 suspected malignant case, 5 specific benign cases and 57 non-specific benign cases. The final diagnoses included 49 malignant cases, 49 benign cases and 3 cases of undiagnosed lesions. The sensitivity, specificity and overall diagnostic accuracy were 80% (39/49), 100% (49/49) and 90% (88/98), respectively. Based on the univariate and multivariate logistic regression analyses, the independent risk factors for diagnostic failure were small tissue sample numbers (P = 0.048) and procedure-related hemoptysis (P = 0.004). Pneumothorax was found in 13 patients (13%). Based on the univariate and multivariate logistic regression analyses, the independent risk factor for pneumothorax was the decubitus position (P = 0.011). Hemoptysis was found in seven patients (7%). Conclusions CT-guided biopsy is a safe and highly accurate diagnostic method for SCLNs.