Computed tomography fluoroscopy-guided percutaneous biopsy of pulmonary nodules ≤ 10 mm: retrospective analysis of procedures performed during the COVID-19 pandemic

Abstract Objective: To evaluate the diagnostic performance of computed tomography (CT) fluoroscopy-guided percutaneous transthoracic needle biopsy (PTNB) in pulmonary nodules ≤ 10 mm during the coronavirus disease 2019 pandemic. Materials and Methods: Between January 1, 2020 and April 30, 2022, a total of 359 CT fluoroscopy-guided PTNBs were performed at an interventional radiology center. Lung lesions measured between 2 mm and 108 mm. Of the 359 PTNBs, 27 (7.5%) were performed with an 18G core needle on nodules ≤ 10 mm in diameter. Results: Among the 27 biopsies performed on nodules ≤ 10 mm, the lesions measured < 5 mm in four and 5-10 mm in 23. The sensitivity and overall diagnostic accuracy of PTNB were 100% and 92.3%, respectively. The mean dose of ionizing radiation during PTNB was 581.33 mGy*cm (range, 303-1,129 mGy*cm), and the mean biopsy procedure time was 6.6 min (range, 2-12 min). There were no major postprocedural complications. Conclusion: CT fluoroscopy-guided PTNB appears to provide a high diagnostic yield with low complication rates.

【摘要】
研究目的：评估2019冠状病毒病（Coronavirus Disease 2019, COVID-19）大流行期间，CT透视（CT Fluoroscopy）引导下经皮经胸针吸活检（Percutaneous Transthoracic Needle Biopsy, PTNB）对直径≤10 mm肺结节的诊断效能。
材料与方法：2020年1月1日至2022年4月30日期间，某介入放射学中心共完成359例CT透视引导下经皮经胸针吸活检术。纳入研究的肺部病变直径范围为2 mm至108 mm。在359例活检术中，27例（占总例数的7.5%）针对直径≤10 mm的肺结节实施，均采用18G核心针完成操作。
结果：在这27例针对≤10 mm肺结节的活检中，4例病变直径<5 mm，23例病变直径为5~10 mm。经皮经胸针吸活检的敏感度及总体诊断准确率分别为100%和92.3%。术中电离辐射平均剂量为581.33 mGy·cm（范围：303~1129 mGy·cm），平均活检操作时长为6.6 min（范围：2~12 min）。术后未出现严重并发症。
结论：CT透视引导下经皮经胸针吸活检可获得较高的诊断阳性率，且并发症发生率较低。