CT-Guided Percutaneous Core Needle Biopsy for Lung Lesions: A 14-Year Review of Needle Angle and Lesion Depth

Background: Increasing success rate and reducing complications are important for computed tomography (CT)-guided percutaneous core needle biopsy (PCNB). Objectives: To assess the influence of needle angle and lesion depth on procedural success and complications of CT-guided PCNB for intrapulmonary lesions, performed by a single radiologist. Patients and Methods: A total of 689 cases of PCNB performed under CT guidance were enrolled in this study. The collected data were retrospectively reviewed. The pathologic results and complications were evaluated for each case. Two factors-needle angle and lesion depth-were statistically analyzed to assess the relationship with procedural success and complications of PCNB by using univariate analysis. Post hoc analysis was performed with Bonferroni’s method. Results: The overall success rate was 93.1% (642/689). Procedural success showed no statistically significant association with both needle angle (P = 0.568) and lesion depth (P = 0.144). The overall complication rate was 17.9% (123/689) with 15.7% for minor complications and 2.2% for major complications. The needle angle had no association with complications (P = 0.101). Presence and severity of complications showed a direct relationship with lesion depth (P < 0.01). In fact, more severe complications occurred in deeper located lesions. Conclusion: Needle angle had no effect on both procedural success and complications. Also, there was no significant correlation between lesion depth and procedural success. However, lesion depth was closely correlated with the incidence and severity of complications after PCNB.