MRI-guided percutaneous coaxial cutting needle biopsy of small pulmonary nodules: feasibility.

OBJECTIVES

To prospectively evaluate the feasibility, safety and accuracy of magnetic resonance imaging (MRI)-guided percutaneous coaxial cutting needle biopsy of small (≤2.0 cm in diameter) pulmonary nodules.

METHODS

Ninety-six patients (56 men and 40 women) with 96 small lung nodules underwent MRI-guided percutaneous coaxial cutting needle biopsy. These lesions were divided into two groups according to maximum nodule diameters: 0.5-1.0 cm (n = 25) and 1.1-2.0 cm (n = 71). The diagnostic accuracy, sensitivity and specificity were calculated, and comparison of the two groups was performed using Fisher's exact test.

RESULTS

All specimens obtained were sufficient for diagnosis. Histological examination of needle biopsy revealed 64 malignant, 30 benign and 2 indeterminate nodules. The final diagnoses from surgery or clinical follow-up were 67 malignant nodules and 29 benign nodules. The diagnostic performance of MRI-guided percutaneous coaxial cutting needle biopsy in diagnosing malignant tumours was as follows: accuracy, 97 %; sensitivity, 96 %; specificity, 100 %; positive predictive value, 100 %; and negative predictive value, 91 %. There was no significant difference between the two groups (P > 0.05, Fisher's exact test). No serious complications occurred.

CONCLUSIONS

MRI-guided percutaneous coaxial cutting needle biopsy is a safe and accurate diagnostic technique in the evaluation of small lung nodules.

KEY POINTS

• MRI-guided biopsy helps clinicians to assess patients with small lung nodules. • Differentiation of malignant and benign nodules is possible with 97 % accuracy. • MRI guidance enables accurate lung biopsy without ionising radiation. • No serious complications occurred in MRI-guided lung biopsy.