ArticleLa Radiologia medica2026
Diagnostic yield and predictors of complications in CT-guided percutaneous lung biopsy: an analysis based on ATS/ACCP criteria.
Article in La Radiologia medica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCT-guided percutaneous lung biopsy (CT-PLB) remains a cornerstone for the diagnosis of pulmonary nodules (PNs), although several alternative techniques, including robotic-assisted bronchoscopy, are increasingly adopted. This study aimed to evaluate CT-PLB in a real-world cohort, focusing on predictors of diagnostic yield and complications.
methodsWe retrospectively evaluated patients who underwent CT-PLB between 2020 and 2024. The diagnostic yield was defined according to the recently published ATS/ACCP criteria. Clinical, radiological, and periprocedural variables were assessed as predictors of diagnostic outcome and complication [pneumothorax (PNX) and pulmonary hemorrhage].
resultsSix hundred fifty-seven patients were included (mean age 69 ± 11 years; 54% male). The diagnostic yield was 84% with higher yield observed for nodule size (diameter ≥ 10 mm), density (solid), and location (peripheral). Increasing subcutaneous fat thickness was independently associated with a modest but significant reduction in diagnostic yield. PNX was radiologically present in 44.4% of cases; however, only 5.9% required hospitalization, and 4.7% required chest-tube placement. Greater parenchymal depth, trans-fissural needle passages, pleural tags and supine and left-lateral decubitus positions were associated with increased PNX extent, while intraparenchymal lesion and greater chest-wall thickness showed a protective effect. Radiological pulmonary hemorrhage >2 cm occurred in 38% of patients, whereas only 1.5% experienced major bleeding requiring intervention. Greater parenchymal depth and non-solid density were associated with increased hemorrhage severity.
conclusionsIn a contemporary diagnostic landscape, CT-PLNB still demonstrates high diagnostic yield and an acceptable safety profile when strict diagnostic criteria are applied. These findings support its continued role as a primary diagnostic approach for PNs.
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