Coskun DOGAN, Murat ASIK, Goksel MENEK, Zeynep Nihal KAZCI, Nur KARABURUN, Gonul Seven YALCIN, Serkan GUNGOR, Ramazan GUNEY
İstanbul Kuzey Klinikleri Dergisi - 2026;13(2):139-147
OBJECTIVE: Investigate radiologic and radiometabolic features affecting the diagnostic success of transthoracic biopsy (TTB) procedures guided by Thoracic Ultrasonography (TUS). METHODS: The electronic medical records of all patients who underwent TUS-guided TTB procedures (TUS-TBB) were retrospectively reviewed. Patients with a final diagnosis of primary lung cancer (LC), established via TUS-TBB or other diagnostic modalities, were included in the study. The cohort was stratified into two groups: those in whom the TUS-TBB procedure was diagnostic and those in whom it was non-diagnostic. Clinical, demographic, radiological [Chest Computed Tomography (CT)], and radiometabolic (PET-CT) characteristics were compared between the two groups. RESULTS: A total of 107 patients with a final diagnosis of lung cancer were included in the study. Of these, 91 (85%) were male, with a mean age of 67.8+/-11.4 years. The mean maximum diameter of the mass lesion on chest CT was 68.2+/-31 millimeters (mm), and the mean maximum standardized uptake value (SUVmax) on PET-CT was 14.1+/-6.9. A necrotic component/ametabolic area within the lesion on PET-CT was present in 43 (40.2%) patients and absent in 64 (59.8%). The most frequent histopathological subtype was adenocarcinoma, observed in 46 (42.9%) cases. While 41 (38.3%) patients underwent transthoracic fine-needle aspiration biopsy (TTFNAB) under TUS guidance, 66 (61.7%) patients underwent tru-cut biopsy (TCB). The TUS-TBB procedure was diagnostically successful in 87 (81.3%) of the cases. The presence of a necrotic component within the lesion on PET-CT was identified as the sole independent risk factor significantly impacting the diagnostic success of the procedure (p=0.010). CONCLUSION: TUS-TBB procedures demonstrate high diagnostic success. In carefully selected patients, pre-procedural evaluation of lesion metabolic activity using PET-CT may enhance the diagnostic success of the biopsy.
