Safer lung biopsy techniques: fewer patients with pneumothorax, fewer chest tube insertions

Image guided transthoracic lung biopsy is a widely accepted technique for the workup of lung lesions (1). Screening for lung cancer and the growing need for research biopsy samples will continue to increase the demand for image guided lung biopsy (2,3). Technical aspects of the procedure have evolved over the years and will continue to change. In the early days, lung biopsies were performed under fluoroscopic guidance. With the widespread use of cross sectional imaging and multidetector CTs, most centers in the US have shifted their practice to performing lung biopsies under CT guidance (4). Others have experimented with C-arm cone-beam computed tomography (CBCT) to combine advantages of real-time fluoroscopic guidance with accuracy of cross sectional imaging (5-7).