Cardiac Motion Non-Influential in Percutaneous Computed Tomography-Guided Biopsies of Small (≤ 20 Mm) Lung Nodules Near Pericardium

To assess the impact of cardiac motion during percutaneous computed tomography (CT)-guided core needle biopsy (PCT-CNB) of small lung lesions near pericardium, focusing on safety and diagnostic accuracy. Seventy-eight PCT-CNBs were performed between March 2010 and June 2018 in 78 patients with small (≤ 20 mm) lung nodules, each within 10 mm of pericardium. Shifts in distance and length of interface separating lesions from pericardium were calculated and compared by cardiac chambers (left atrium, left ventricle, right atrium, or right ventricle). Risk factors for complications were subjected to univariate analysis, and diagnostic accuracy was assessed. The respective mean values were 0.8 ± 1.1 mm (range 0–5.1 mm) for shifts in distance and 1.5 ± 2.1 mm (range 0–10.8 mm) for length of interface. Neither parameter shifted significantly with respect to cardiac chambers (p > 0.05, both). Pneumothorax ensued in 28 patients (35.9%), and pulmonary hemorrhage occurred in 41 (52.6%). The overall sensitivity, specificity, and accuracy of PCT-CNB were 91.2%, 100%, and 93.2%, respectively. Our data indicate that cardiac motion has no impact on either the incidence of complications or the diagnostic accuracy of PCT-CNB in patients with small (≤ 20 mm) lung lesions near pericardium.