Conventional versus Aspiration-type Needles in CT-guided Biopsy for Chest Pathologies/Lesions: A Comparative Study

Background: Larger sample volume can be obtained in one needle pass using an aspiration-type semi-automatic cutting biopsy needle (STARCUT (R) aspiration-type needle; TSK Laboratory, Tochigi, Japan) in comparison to the conventional semi-automatic cutting biopsy needle. Objective: To evaluate and compare the safety and effectiveness of aspiration-type semi-automatic cutting biopsy needles and non-aspiration-type biopsy needles when performing computed tomography (CT)-guided core needle biopsies (CNBs). Methods: A total of 106 patients underwent CT-guided CNB for chest lesions between June 2013 and March 2020 at our hospital. Non-aspiration-type cutting biopsy needles were used in 47 of these patients, while aspiration-type needles were used in the remaining 59 patients. All needles used were 18- or 20-gauge biopsy needles. Parameters, like forced expiratory volume in 1-second percent (FEV1.0%), the maximum size of the target lesion, puncture pathway distance in the lung, number of needle passes, procedure time, diagnostic accuracy, and incidence of complications, were measured. Comparisons were made between the needle-type groups. Results: No significant difference was observed in terms of diagnostic accuracy. However, the procedure time was shorter and a lesser number of needle passes were required with the aspiration-type cutting biopsy needle compared to the non-aspiration-type needle. Pneumothorax and pulmonary hemorrhage were the complications encountered, however, their incidence was not significantly different between the two types of needles. Conclusion: The aspiration-type semi-automatic cutting biopsy needle had similar diagnostic accuracy as the non-aspiration-type biopsy needle, with added advantages of a lesser number of needle passes and shorter procedure time.