Impact of thoracoscopic lung biopsy versus per - cutanous CT guided needle biopsy in peripheral lung lesions

ABSTRACT

To determine the diagnostic yield of the thoracoscopic lung biopsy versus per-cutaneous CT guided needle biopsy in realizing the etiology of peripheral lung lesions, using the spiral CT scan as positioning guidance. The study included 30 patients, with undiagnosed peripheral lung lesions, who were subjected to thorough clinical history and examination, -plain X- ray, routine laboratory investigations, CT chest and CT guided biopsy and thoracoscopy with thoracoscopic lung biopsy. The final diagnosis were 23 malignant lesions and 7 benign lesions. The sensitivity of CT guided biopsy was 78.3% with 100% specificity while the sensitivity of thoracoscopic biopsy was l00% with 100% specificity. The lesion size was a significant factor contributing to diagnostic accuracy of CT guided biopsy. Thoracoscopic biopsy provides higher degree of accuracy for specific benign diagnosis in peripheral pulmonary lesions. Percutaneous transthoracic CT guided needle biopsy is an important scanning tool in diagnosing peripheral pulmonary lesions greater than 2 cm in diameter. Thoracoscopic biopsy is an important tool in diagnosing peripheral pulmonary nodules whether small or large nodules. Thoracoscopy provides higher degree in accuracy for specific benign diagnosis in peripheral pulmonary lesion versus CT guided biopsy. Thoracoscopy provides higher degree of accuracy compared with CT guided biopsy for diagnosis of peripheral pulmonary lesions