Constantinescu Amalia, Stoicescu Emil Robert, Iacob Roxana, Chira Cosmin Alexandru, Cocolea Daiana Marina, Nicola Alin Ciprian, Mladin Roxana, Oancea Cristian, Manolescu Diana
Doctoral School, 'Victor Babes' University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 6 No. 2, 300041 Timisoara, Romania.
Radiology and Medical Imaging University Clinic, Department XV, 'Victor Babes' University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania.
J Clin Med. 2024 Dec 2;13(23):7330. doi: 10.3390/jcm13237330.
CT-guided transthoracic core-needle biopsy (CT-TTNB) is a minimally invasive procedure that plays a crucial role in diagnosing pulmonary nodules. With high diagnostic yield and low complication rates, CT-TTNB is favored over traditional surgical biopsies, providing accuracy in detecting both malignant and benign conditions. This literature review aims to present a comprehensive overview of CT-TTNB, focusing on its indications, procedural techniques, diagnostic yield, and safety considerations. Studies published between 2013 and 2024 were systematically reviewed from PubMed, Web of Science, Scopus, and Cochrane Library using the SANRA methodology. The results highlight that CT-TTNB has a diagnostic yield of 85-95% and sensitivity rates for detecting malignancies between 92 and 97%. Several factors, including nodule size, lesion depth, needle passes, and imaging techniques, influence diagnostic success. Complications such as pneumothorax and pulmonary hemorrhage were noted, with incidence rates varying from 12 to 45% for pneumothorax and 4 to 27% for hemorrhage. Preventative strategies and management algorithms are essential for minimizing and addressing these risks. In conclusion, CT-TTNB remains a reliable and effective method for diagnosing pulmonary nodules, particularly in peripheral lung lesions. Advancements such as PET/CT fusion imaging, AI-assisted biopsy planning, and robotic systems further enhance precision and safety. This review emphasizes the importance of careful patient selection and procedural planning to maximize outcomes while minimizing risks, ensuring that CT-TTNB continues to be an indispensable tool in pulmonary diagnostics.
CT引导下经胸芯针活检（CT-TTNB）是一种微创手术，在肺结节诊断中起着关键作用。由于诊断率高且并发症发生率低，CT-TTNB比传统手术活检更受青睐，在检测恶性和良性病变方面都具有准确性。这篇文献综述旨在全面概述CT-TTNB，重点关注其适应证、操作技术、诊断率和安全注意事项。使用SANRA方法，对2013年至2024年间发表在PubMed、科学网、Scopus和Cochrane图书馆的研究进行了系统综述。结果表明，CT-TTNB的诊断率为85%-95%，检测恶性肿瘤的敏感度为92%-97%。包括结节大小、病变深度、穿刺次数和成像技术在内的几个因素会影响诊断成功率。注意到有气胸和肺出血等并发症，气胸的发生率为12%-45%，出血的发生率为4%-27%。预防策略和处理方案对于将这些风险降至最低并加以应对至关重要。总之，CT-TTNB仍然是诊断肺结节的可靠且有效的方法，尤其是对于外周肺病变。PET/CT融合成像、人工智能辅助活检规划和机器人系统等进展进一步提高了精准度和安全性。本综述强调了谨慎选择患者和进行操作规划的重要性，以在将风险降至最低的同时最大化治疗效果，确保CT-TTNB仍然是肺部诊断中不可或缺的工具。
