Comparison of computed tomography-guided core needle biopsy of pulmonary nodules performed with and without the coaxial technique.

Introduction: Computed tomography (CT)-guided core needle biopsy (CNB) is a common method for diagnosing pulmonary nodules (PNs). It is often performed using the coaxial technique (CAT) to streamline the process.

Aim: This study aimed to compare the safety and diagnostic performance of CT-guided CNB with and without CAT for diagnosing PNs.

Materials and methods: This retrospective analysis included patients undergoing CT-guided CNB for a diagnosis of PNs between January 2017 and December 2019. The study population was divided according to the use of CAT for the biopsy. Procedure-related data, diagnostic accuracy and yield, and complication rates were compared between the 2 groups.

Results: During the study period, a total of 111 and 108 patients underwent CT-guided CNB with and without CAT, respectively. As compared with the non-CAT group, the CAT group showed a lower mean needle pathway number (P <⁠0.001), a higher mean sample number (P <⁠0.001), and shorter procedural duration (P <⁠0.001). Diagnostic accuracy was similar between the 2 groups (98.3% vs 96.3%, respectively, for CAT vs non-CAT; P = 0.6), though the CAT group demonstrated a higher diagnostic yield than the non-CAT group (81.4% vs 68.5%; P = 0.03). Pneumothorax and pulmonary hemorrhage rates did not differ between the 2 groups (P = 0.09 and P = 0.16, respectively).

Conclusions: CT-guided CNB with CAT demonstrated greater procedural efficiency, with fewer needle pathways, shorter operative duration, and improved diagnostic yield, as compared with procedures performed without CAT.