Ultrasound-guided (USG) Tru-Cut biopsies of thoracic masses performed by respiratory physicians.

<bold>Background:</bold> There has been a lot of effort in the UK to improve the diagnostic pathway of patients with suspected lung cancer. Our lung cancer service has been identifying patients suitable for USG Tru-Cut biopsies to shorten time to diagnosis. <bold>Aims:</bold> To assess the diagnostic accuracy and safety of USG Tru-Cut biopsies of thoracic masses and the time to biopsy and treatment decision. <bold>Methods:</bold> Retrospective review of Tru-Cut biopsies of thoracic masses performed during 2021-2023. <bold>Results:</bold> 45 Tru-Cut biopsies have been performed. The mean age of patients was 71 years. 71.1 % (n=32) were males. There have been 26 (57.8%) lung masses, 16 (35.6%) pleural based masses and 3 (6.7%) mediastinal masses biopsied. The biopsy was diagnostic in 97.8% (n=44), with only 8.9% (n=4) cases requiring further biopsy for immunohistochemistry or molecular markers. The complications rate was low at 6.7% (n=3). Only 1 patient required a procedure (intercostal chest drain) to manage a complication. The biopsies confirmed malignancy in 93.3% (n=42). The biopsies confirmed non-small cell lung cancer in 46.7% (n=21), small cell lung cancer in 17.8% (n=8), mesothelioma in 13.3% (n=6), other cancers in 13.3 % (n=6) and benign causes in 6.7% (n=3). The mean time from referral to biopsy was 7.8 days, with 46.7 % (n=21) performed within 5 days of the referral. Prompt biopsy allowed multi-disciplinary discussion within 21 days in 68.9% (n=31), reaching treatment decision in 75.6% (n=34) within 28 days. <bold>Conclusions:</bold> Respiratory physicians can perform USG biopsy of thoracic masses safely with excellent diagnostic accuracy. This leads to improving diagnostic pathway for patients by shortening the time to biopsy and treatment.