[CT-guided punctures: fine-needle biopsy vs. automated co-axial cutting biopsy].

Purpose: Comparison between fine needle aspiration (FNAB) and automated coaxial core biopsy (ACCB) of CT-guided thoracal and abdominal biopsies.

Method: 98 patients had CT-guided biopsies of the liver (n = 26), lung (n = 36), pancreas (n = 8), presacral space (n = 16), retroperitoneum (n = 8), groin (n = 1) and mediastinum (n = 3). In 50 patients fine needle aspiration, in 48 patients ACCB was performed. Nine physicians, two of them with advanced experience, performed the procedure.

Results: Histologically satisfying material was achieved in 76% of the biopsies with FNAB, in 100% with ACCB. The sensitivity within the FNAB group was 59.6%, within ACCB group 97.5%. Sensitivity for the whole group was 76.7%. In pulmonary lesions the sensitivity was increased to 100% by using the ACCB method in comparison to FNAB (58%), in liver lesions from 75% (FNAB) to 92% (ACCB). 19 of 20 false negative specimens were obtained with FNAB. The less experienced physicians had a false negative rate of 43% with FNA biopsies, but only 2.2% with ACCB.

Conclusion: In pulmonary and abdominal lesions ACCB is a procedure with rare complications and low invasivity, which is not dependent on the performing person. ACCB has a high diagnostic accuracy and should replace FNAB.