Diagnostic Yield for Cancer and Diagnostic Accuracy of Computed Tomography-guided Core Needle Biopsy of Subsolid Pulmonary Lesions

Purpose: We aimed to determine the diagnostic yield for cancer and diagnostic accuracy of computed tomography-guided core needle biopsy (CTNB) in subsolid pulmonary lesions. Materials and Methods: Fifty-two biopsies of 52 subsolid lesions in 51 patients were identified from a database of 912 lung biopsies and analyzed for the diagnostic yield for cancer and diagnostic accuracy of core CTNB diagnosis as well as complication rates. Results: When indeterminate biopsy results were included in the analysis, the diagnostic yield for cancer was 80.8% and the diagnostic accuracy of core needle biopsy was 84.6% (n = 52). It was 85.7% and 91.7%, respectively, when indeterminate results were excluded (n = 48) and 82.4% and 82.4%, respectively, for biopsies with surgical confirmation (n = 17). Attenuation was statistically significant for diagnostic yield for cancer (P = 0.028) and diagnostic accuracy of core needle biopsy (P = 0.001) when the indeterminate results were excluded (n = 48). Attenuation and size were not statistically significant for diagnostic yield for cancer and diagnostic accuracy of needle biopsy (n = 52), and size was not statistically significant for either when the indeterminate results were excluded. These results were achieved without any major complications as per the Society of Interventional Radiology Standards of Practice. Conclusions: CTNB offers a high yield in establishing a histopathologic diagnosis of subsolid pulmonary lesions, with both ground-glass and solid-predominance. The pure ground-glass category of lesions requires further research to determine the true diagnostic yield and diagnostic accuracy of core needle biopsies.