Purpose: To evaluate four automated devices to achieve transthoracic lung biopsy.
Methods: Transthoracic lung biopsy specimens were obtained randomly from 21 human cadavers with unsuspicious lungs using Biopty (18- and 20-gauge), BIP (18 and 20-gauge), ASAP (18 gauge), and Autovac (18- and 20-gauge) devices. A total of 63 biopsies were carried out with each device and each needle diameter. The same devices and needles were then used randomly for biopsy of peripheral lung metastases. Specimens obtained during both parts of the study were analyzed for the area of tissue on the histologic section, adequacy of tissue for diagnosis, tissue preservation, and crush artifact. The examining pathologist was kept unaware of which procedure was used to obtain the specimens and the cadavers' clinical history.
Results: The Biopty 18-gauge device performed statistically better than any other of the evaluated systems for biopsy of normal lung parenchyma (p < 0.05). For biopsy of lung metastases, the differences between the devices and needle diameters were less, although the Biopty 18-gauge device performed better than the Autovac 18-gauge, BIP 18-gauge, and all 20-gauge devices for the area of tissue on the histologic section (p < 0.05). The results of the full-cut Autovac biopsy system were remarkable because of the large number of biopsies during which no tissue was obtained.
Conclusion: Automated biopsy devices can obtain high quality lung specimens sufficient for definite histopathologic diagnosis. However, additional clinical studies on the use of automated biopsy devices for lung biopsy are mandatory.