We wanted to evaluate the diagnostic benefits and safety of performing CT-guided transthoracic needle biopsy (TTNB) with using an18-gauge automated cutting needle.

We retrospectively reviewed the medical records of 332 patients who underwent CT-guided transthoracic biopsy with an automated 18-gauge cutting needle for 341 thoracic lesions. The histopathologic results, diagnostic accuracy and complication rate were determined.

316 (92.7%) of 34l lesions were histopathologically diagnosed by CT-guided TTNB. The lesions were malignant in 172 patients and benign in 144 patients. The diagnostic accuracy was 92.9%. The sensitivity and specificity for malignant lesions were 93% and 92.3%, respectively. The sensitivity and specificity for benign lesions were 92.3% and 93%, respectively. TTNB induced complications developed for 54 of 341 (15.8%) procedures. The most frequent complication was pneumothorax (41/341, 12%). Nine patients with pneumothorax (9/41, 22%) required chest tube placement.

CT-guided TTNB with an 18-gauge automated cutting needle could be useful for making the histopathologic diagnosis of malignant and benign pulmonary lesions as the technique provides a big enough tissue sample for histopathologic examination. The procedure-related complication rate was acceptably low.