Intrathoracic lesions, encompassing pulmonary, pleural, and mediastinal masses, necessitate histopathological assessment for precise diagnosis. Image-guided percutaneous biopsy has emerged as a technique to attain this. This study evaluates its utility, reasons for inconclusive results, and associated complications.

Methods: 120 patients, who had prior imaging indicating an intrathoracic lesion, were enrolled post-ethical committee clearance and obtaining informed consent. The biopsy was conducted using Siemens 128 slice CT scanner or GE 16 slice CT scanner. Feasibility for image-guided biopsy was determined and procedures were executed. A follow-up evaluation comprised:

a) Histopathology outcomes.

b) Reasons for inconclusive results.

c) Complications, their management, and effect on the patient's clinical outcome.

Results: Conclusive histopathological results were received in 89.1% of cases, aligning with existing literature standards. The findings were significantly valuable for the attending physician. Factors leading to inconclusive results included small lesion size, intraprocedural complications, necrotic core biopsies, and the need for additional samples for IHC examination. Complications, primarily pneumothorax and hemorrhage, were observed in 22% of participants. This rate is consistent with prevailing literature. Most complications were conservatively managed, with only 4.1% requiring further intervention. Monitoring the patients' clinical status revealed symptomatic improvements, affirming the safety and reliability of the biopsy method for intrathoracic lesions.

Conclusion: Image-guided percutaneous biopsy of intrathoracic lesions stands as a safe and dependable technique, offering low complication rates and significant diagnostic insight into pulmonary, pleural, and mediastinal masses