Which procedure has a diagnostic yield of about 60% and is most commonly performed under CT guidance?

Which procedure has a diagnostic yield of about 60% and is most commonly performed under CT guidance?

• A. Needle biopsy
• B. Bronchoscopy
• C. Thoracentesis
• D. Mediastinoscopy

Answer: (A)

When you need a tissue diagnosis from a lung lesion, the goal is to obtain a sample with the least invasiveness while hitting the target accurately. CT-guided percutaneous needle biopsy does exactly that: a needle is advanced through the chest wall into the lesion under CT guidance to extract tissue for histology. This approach is widely used because it directly samples the nodule and can be done on an outpatient basis, with a diagnostic yield around 60% in many practical settings, particularly for small to moderately sized nodules. The CT guidance is key because it allows precise trajectory planning to reach the lesion while avoiding vital structures. Bronchoscopy is excellent for lesions that are central or accessible through the airways, but peripheral nodules often yield less and it is not primarily performed under CT guidance. Thoracentesis targets pleural effusions and provides cytology or fluid analysis, not solid lesion sampling. Mediastinoscopy is an invasive surgical procedure to sample mediastinal nodes and is not CT-guided. Thus, the CT-guided percutaneous needle biopsy best fits the description.

When you need a tissue diagnosis from a lung lesion, the goal is to obtain a sample with the least invasiveness while hitting the target accurately. CT-guided percutaneous needle biopsy does exactly that: a needle is advanced through the chest wall into the lesion under CT guidance to extract tissue for histology. This approach is widely used because it directly samples the nodule and can be done on an outpatient basis, with a diagnostic yield around 60% in many practical settings, particularly for small to moderately sized nodules. The CT guidance is key because it allows precise trajectory planning to reach the lesion while avoiding vital structures.

Bronchoscopy is excellent for lesions that are central or accessible through the airways, but peripheral nodules often yield less and it is not primarily performed under CT guidance. Thoracentesis targets pleural effusions and provides cytology or fluid analysis, not solid lesion sampling. Mediastinoscopy is an invasive surgical procedure to sample mediastinal nodes and is not CT-guided. Thus, the CT-guided percutaneous needle biopsy best fits the description.