CT-guided percutaneous needle biopsy of the chest: preprocedural evaluation and technique.

Indications Percutaneous needle biopsy of the lung is indicated for indeterminate pulmonary nodules or masses, particularly those that will likely require chemotherapy or radiation rather than surgery, and in patients with a history of extrapulmonary malignancy. Because targeted therapy has now become an important part of the armamentarium for treatment of lung cancer, percutaneous needle biopsy of the lung is also performed to obtain tissue for molecular testing. Recent studies have confirmed that epidermal growth factor receptor (EGFR) mutations seen in lung cancer patients can be detected from fine-needle aspiration specimens, thereby helping to identify patients who would benefit from EGFR tyrosine kinase inhibitors [6, 7]. Similarly, other information, such as estrogen and progesterone receptor status of breast cancer metastases, also can be ascertained by percutaneous needle biopsy of the lung. The procedure is also useful for obtaining samples for the diagnosis of focal pulmonary infection. Mediastinal, pleural, and chest wall lesions also are frequently accessible by needle biopsy.