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"Liquid withdraw" technique in CT-guided cutting needle lung biopsy: Decreased incidence of complications and increased tissue amount for lung cancer molecular testing

Abstract Background CT-guided percutaneous biopsy is a minimally invasive technique used for obtaining enough tissue samples in the diagnosis of pulmonary lesions. The common complications of CT-guided percutaneous lung biopsy include pneumothorax, hemoptysis. Coaxial technique makes it much easier to repeat sampling and obtain adequate specimens, still it makes no change to the high incidence of pneumothorax. Basic on the research De Filippoet al. had done about complications, we hypothesis that when the inner chuck of coaxial guiding needle was removed and the cutting needle was placed inside the guiding needle, the injection of a small amount of liquid (a mixture of lidocaine and hemocoagulase) through the syringe while withdraw of the guiding needle may help to prevent the incidence of pneumothorax for which close the needle track with liquid. Methods From August 24th, 2018 to April 1th ,2019, a total of 32 CT-guided percutaneous transthoracic biopsy procedures performed in 32 patients were retrospectively evaluated. The patients were divided into groups regarding the lesion from pleural surface: Results Pathology results were malignant in 28 patients (17 cases were adenocarcinoma), benign in 4 patients.7 cases (21.9%) happened pneumothorax (4 very mild pneumothorax, 2 mild pneumothorax, 1 moderate pneumothorax),13 cases (40.6%) happened pneumorrhagia (12 mild pneumorrhagia, 1 very mild pneumorrhagia). And there was no statistically significant between pneumothorax and the depth of lesion to pleural surface (P > 0.05). Conclusions Compared to co-axial technique only, CT-guided percutaneous lung biopsy using co-axial combined with "liquid withdraw" significantly reduced the incidence of pneumothorax, which has been confirmed what we found in earlier retrospective study. The new technique provided an more accurate, secure and reliable way to obtain adequate tissue samples in the diagnosis. Legal entity responsible for the study Comprehensive Cancer Center of Drum-Tower Hospital. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.