CT guided lung biopsy - step by step guide

Equipment required

1. 

1. Skin surface marker grid

   2

   .  Co
2. Co-axial biopsy set

   3

   .  Basic
3. Basic procedure pack with lidocaine, as for any minor procedure.

Step 1:   Perform a limited CT of the chest with the skin surfaces markers in place, over the planned site of entry.

You can make your own surface marker grid for these purposes - see Surfacesurface marker grid for CT guided biopsy.

Step 2:  Check of inflitrationinfiltration needle position and angulation in relation to the mass.

EnsuresEnsure it is on track, no patient movement, etc, before the co-axial needle is placed.

Tip: Use lung windows and 'narrow' the windows to see the needle optimally.

Step 3:  Insert the co-axial needle in as far as, but not through the pleura.

Re-check alignment.

** Note: in this case note adjustment is needed for ideal angulation prior to the next step breeching the pleura.

Step 4:  Re-alignment of the co-axial needle performed.

The co-axial is nonow perfectly placed for taking the biopsy.

The minimal time necessary with the pleura breeched and no re-positioning after pleura breeched has been necessary.

CT guided thoracic (lung) biopsy is a everyday important procedure undertaken in clinical radiology departments.

The majority of biopsies are in those with presumed lung cancer, although a wider spectrum of pathologies in both the lung and mediastinum may be biopsied.

Technique and a measured approach is key.   The procedure is not without complication, the chief and most frequent being pneumothorax.

This case guides the unfamiliar in a step-by-step manner how to undertake the procedure.