Diagnostic efficacy of transthoracic fine needle aspiration biopsy in lung lesions and comparative evaluation of complications with the literature

INTRODUCTION: To examine the diagnostic accuracy and complication profile of CT-guided transthoracic fine needle aspiration biopsy (TTFNAB) in patients presenting with pulmonary lesions, while also reviewing these outcomes in light of current literature.
METHODS: This retrospective study included 102 patients who underwent CT-guided TTFNAB between April 2020 and June 2022 at a tertiary care center. All procedures were carried out by three radiologists, each possessing a minimum of two years of experience in the field of interventional radiology. Diagnostic yield, complication rates (pneumothorax, hemorrhage, hemoptysis), and lesion characteristics were recorded. Results were statistically analyzed and compared with recent literature.
RESULTS: TTFNAB provided a diagnostic yield of 98%. Malignancy was detected in 76.5% of cases, with adenocarcinoma and squamous cell carcinoma being the most common subtypes. Pneumothorax occurred in 12.7% of cases, tract-perilesional hemorrhage in 21.6%, and hemoptysis in 2%. Lesions located away from the pleura had significantly higher pneumothorax and bleeding rates (p=0.013 and p=0.0005, respectively). No significant correlation was found between complication rates and gender, lesion location, presence of emphysema, or procedure position.
DISCUSSION AND CONCLUSION: CT-guided TTFNAB is a highly effective and relatively safe diagnostic tool for lung lesions. While complication rates are acceptable, lesion proximity to the pleura significantly influences risk. Findings are consistent with the literature and support the continued use of TTFNAB in appropriate clinical settings.