Efficacy of imaging-guided transthoracic needle lung biopsy - a single center retrospective study

<bold>Introduction:</bold> Early-stage lung cancer diagnosis remains a global challenge, demanding a less invasive, cost-effective, and time-efficient sampling technique. Percutaneous imaging-guided lung biopsy meets these criteria. <bold>Aims and Objectives:</bold> This study evaluates the efficacy of imaging-guided transthoracic needle lung biopsy and identifies factors predicting periprocedural complications and diagnosis success. <bold>Methods:</bold> A single-center retrospective study included 280 patients between 2021-2023 (19 ultrasound-guided biopsy, 261 CT scan-guided percutaneous biopsy). <bold>Results:</bold> Histopathological results were obtained in 268 cases (95.71%), with 12 inconclusive specimens (4.29%). We identified 226 malignant tumors (80.71%) and 42 other diseases (15%). Of the 226 malignant tumors, 193 (85.39%) were NSCLC. A higher number of samples did not significantly correlate with a conclusive biopsy (p=0.069), which might suggest specimen quality`s importance. Advanced lung cancer (metastasis) showed no significant correlation (p=0.35) in diagnostic rate. Periprocedural complication rates were higher with age (p=0.046), while COPD and smoker status did not significantly elevate risk (p>0.05). Additionally, more samples did not correlate with complications (p=0.069).CT-guided technique offered more fragments (p=0.01). Central localization had no significant risk of complications (p=0.086), while lower lobe lesions showed a significant risk (p=0.043). <bold>Conclusions:</bold> The study highlights the utility of percutaneous lung biopsy. The high confirmation rate and manageable impact of complications emphasize its diagnostic importance. However, older individuals and lower lobe lesions localizations require higher attention.