A Study on the Clinical Application of Jiang's Percutaneous Transthoracic Lung Biopsy in Pulmonary Nodules

Background: Lung cancer has a high global mortality rate, and CT-guided percutaneous lung biopsy is used for lung biopsy. We invented a laser-assisted puncture system named Jiang’s percutaneous transthoracic lung biopsy to assist diagnose. Methods: Jiang's PTLB optimizes CT-guided percutaneous lung puncture via a simple homemade laser-guided puncture device with two laser devices to determine the angle and level of puncture. We recruited 34 physicians to perform a self-controlled trial of the model via two methods to evaluate its effectiveness. A total of 390 patients from January 2021 to July 2023 underwent Jiang’s method and 129 patients from March 2020 to July 2023 underwent the conventional method. Results: 1. Model experiment results: Jiang's method resulted in a higher single penetration rate (76.5% vs. 11.8%), shorter operation time (3.04±1.12 minutes vs 8.43±2.48 minutes), fewer CT scans (1.24±0.43 times vs. 3.91±1.06 times), and fewer penetrations (1.24±0.43 vs. 2.91±1.06); 2. Clinical trial results: In Jiang’s group, pneumothorax was developed in 31 patients (12.02%), bleeding occurred in 20 patients (7.75%), and 4 patients bled (1.55%). Jiang's method had a sensitivity of 94.19%, a specificity of 97.30%, a Youden index of 0.9149, a positive predictive value of 99.32%, a negative predictive value of 80.00%, a malignancy rate of 89.57%, a benign detection rate of 75.00%, and a concordance rate of 86.26%. Conclusion: Compared with the unassisted method, Jiang's method can significantly improve the puncture efficiency, reduce the incidence of complications, and increase the safety and effectiveness of the lung biopsy.