Transthoracic needle biopsy for diagnosis of lung cancer

Background: Lung cancer is the most common cause of cancer deaths worldwide and accounts for approximately 2 million deaths annually. Despite advances in lung biopsy methods using bronchoscopy, a transthoracic needle biopsy continues to be used widely owing to its excellent accessibility and cost-effectiveness.Current Concepts: Various guidance methods are used during a transthoracic needle biopsy to guide the biopsy needle toward the target lesion. Commonly used modalities include conventional computed tomography, computed tomography fluoroscopy, cone beam computed tomography, and ultrasonography. Complications of a transthoracic needle biopsy include pneumothorax (20.0%), hemorrhage or hemoptysis (11.0%), delayed pneumothorax (1.4%–4.5%), air embolism (0.02%–1.8%), and tumor seeding (0.12%–0.061%).Discussion and Conclusion: Careful selection of the guidance method and needle type, based on the risk factors, the patient’s condition, and location of the lesion is important to achieve high accuracy and low complication rates during a transthoracic needle biopsy. If possible, the bronchoscopic approach should initially be attempted in high-risk groups.