Image-Guided Biopsy for Lung Cancer A. Axial prone NECT of | Figure 1

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Image-Guided Biopsy for Lung Cancer

A. Axial prone NECT of a 72-year-old man obtained during biopsy of a 2.4 cm left lower lobe nodule (arrow) is shown. Under CT guidance, a 19-gauge Ultrathin needle was advanced into the nodule and 3 passes were made with a 22-gauge needle, with specimens submitted to pathology. The patient was discharged after chest radiography showed no complication.

B. High-power photomicrograph of the same patient (H&E stain, x 400) shows adenocarcinoma with lepidic (arrow) and acinar components. (Courtesy B. Aswad, MD.)

C. NECT of a 40-year-old woman shows a biopsy needle advancing into a 1.5 cm right lower lobe nodule (arrow). Biopsy of nodules in this location is challenging due to significant respiratory motion. Right side down positioning optimized the biopsy approach by nearly eliminating respiratory motion.

D. Axial NECT obtained during biopsy of a 2.5 cm left lower lobe nodule shows ground-glass opacity (arrow) posterior to the needle consistent with hemorrhage. Post biopsy hemorrhage has been reported to protect against pneumothorax.

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