Diagnostic Value of Ultrasound-Guided Core Needle Biopsy in the Diagnosis of Pulmonary Masses at Ho Chi Minh City Oncology Hospital

Abstract

Histopathological confirmation is essential for the diagnosis of pulmonary masses. Although computed tomography (CT)-guided transthoracic biopsy is widely used, it remains associated with a relatively high complication rate, especially pneumothorax. Ultrasound-guided core needle biopsy is a practical alternative for peripheral lung lesions abutting the pleura. This study aims to evaluate the diagnostic performance and safety of ultrasound-guided core needle biopsy for pulmonary masses at Ho Chi Minh City Oncology Hospital. A cross-sectional descriptive study was conducted in 136 consecutive patients with peripheral pulmonary masses visible on ultrasound who underwent ultrasound-guided core needle biopsy from July 2024 to February 2025. Demographic characteristics, lesion size, depth, pleural contact length (PCL), procedure time, number of tissue cores, pathological results, and complications were analyzed. The mean age was 62.3 ± 11.1 years, and 72.8% of patients were male. Definitive histopathological diagnosis was achieved in 128/136 cases (94.1%). Malignancy was identified in 107 cases (78.7%), including 90 primary lung malignancies and 17 metastatic lesions. Mean procedure time was 15.6 minutes, and a mean of 4.9 ± 1.17 cores was obtained per patient. Pneumothorax occurred in 10 patients (7.4%), all mild and self-limited, and mild hemoptysis occurred in 2 patients (1.5%). No severe complications or procedure-related deaths were observed. Ultrasound-guided core needle biopsy is a safe, efficient, and accurate technique for diagnosing peripheral pulmonary masses. It provides a high diagnostic yield with a low complication rate and is a valuable first-line biopsy approach for appropriately selected pleural-based lung lesions.