The purpose of this study is to compare the features that the pathologist sees, when
examining a lung tumor under the microscope, to the way that the tumor appears on the
computed tomography (CT) scan. Features of the tumor may include abnormal blood vessels and
areas in which tumor cells are dying. The samples that are taken during the needle biopsy
contain information from one small part of the tumor. The investigators believe that they
can show where in the tumor the samples came from, based on the CT scans during the biopsy
procedure. If the investigators can accurately determine where in the tumor their samples
came from, they can compare the features of that part of the tumor, as seen on the CT
images, to the features of that part of the tumor as seen under the microscope. This
research study also will give the investigators an idea of how much the biopsy samples are
distorted in the process of preparing them for examination under the microscope.
Newer cross-sectional imaging methods allow improved visualization of anatomic detail—for
example, high-resolution CT has a spatial resolution of less than 1 mm in all 3 dimensions.
These imaging methods also provide a limited amount of physiologic information—for example,
tumor perfusion as demonstrated by enhancement with intravenous contrast agents.
Radiologic-pathologic correlation in the current era gives us the opportunity to work on a
finer spatial scale and to take advantage of the additional physiologic information.
Pathologic assessment of tissue has evolved at the same time. Tissue can be stained in the
traditional way for microscopic evaluation but newer tools such as immunohistochemistry and,
most recently, methods of molecular biology can be applied as well.
We are interested in radiologic-pathologic correlation in lung tumors. Tumors are known to
be heterogeneous; we want to develop an approach that will allow us to explore their spatial
organization. We cannot rely on surgical resection to provide tissue for pathologic
evaluation, because the majority of lung lesions never come to resection. For example, only
~15% of lung cancer patients are surgical candidates. The remainder would be lost to the
classical approach that depends on surgery. Percutaneous needle biopsy provides an
alternative means of tissue sampling. This is a safe, effective and commonly used way to
obtain samples of tissue ("core samples") from any given lung mass. The pathologist can
process these core samples in the same way as a surgical specimen.
- Subjects who have a lung tumor that is likely to be malignant
- Subjects who have been referred for percutaneous needle biopsy
- The target lesion must be at least 10 mm in short-axis dimension.
- Subjects must have intravenous access.
- No history of significant allergy to intravenous contrast.
- Subjects must have sufficient renal function to receive intravenous contrast for
enhancement of the CT images.
- Vulnerable populations will be excluded.
- Subjects who lack the capacity to provide consent
- Subjects who are pregnant