Percutaneous Lung Biopsies: The Basics

In this episode, Dr. Fred Lee and our host Dr. Chris Beck discuss tips for achieving safe and successful percutaneous lung biopsies.

They start by discussing the increasing popularity of core biopsy (as opposed to fine needle aspiration), since an adequate amount of specimen is needed for genetic testing and personalized medicine. Dr. Lee emphasizes that knowing the goals of lung biopsy for each individual patient helps him decide how much specimen to collect and how the specimen should be handled.

Next, Dr. Lee walks through his lung biopsy technique. He outlines the difference between conventional CT and CT with fluoroscopy. While CT with fluoroscopy can be more efficient, it poses radiation risk to the patient and the physician. To minimize radiation risks, he advises IRs to intermittently tap the foot pedal and stand lateral to the CT scanner. The doctors also discuss some of the trickiest lung regions to biopsy and ways to avoid pneumothorax.

Finally, Dr. Lee comments on the choice between percutaneous lung biopsies and electromagnetic navigation bronchoscopy, noting that each procedure has different advantages and risks. He encourages interventional radiologists and interventional pulmonologists to explore these options and take evidence-based approaches.

Throughout this episode, we cite data from Dr. Lee’s previous publications, which are cited below.