CT Guided Biopsy

I do not favor CT guided biopsy in patients who are surgical candidates and in whom the probability of malignancy is high. A positive yield and a non-diagnostic yield will both result in the same decision; surgery. Then why do the procedure? There is also a small risk of tumor spread to the biopsy site. Even if the biopsy shows that it is small cell cancer, the recommended option for this mode of presentation for SCC is resection followed by chemotherapy.

I usually reserve FNAB under the following circumstances:

• When the patient is not a surgical candidate because of COPD or cardiac disease, radiation therapy can be offered only after establishment of diagnosis.
• When the patient has metastatic disease and does not have an operable lesion. Establishment of diagnosis will be necessary for chemotherapy and/or palliative radiation.
• Where the probability of inflammatory process is high, FNAB can establish infectious etiology for the lesion.