Abstract Background Computed tomography (CT)-guided percutaneous lung biopsy remains a cornerstone in the diagnosis of pulmonary nodules; yet it is frequently complicated by pneumothorax, hemorrhage, and hemoptysis. Laser-assisted CT-guided biopsy (LACT) has been proposed to enhance procedural precision and improve safety. This meta-analysis aimed to systematically compare the efficacy and safety of LACT versus conventional CT-guided (CCT) lung biopsies. Methods A comprehensive search of six electronic databases was performed to identify studies comparing LACT and CCT lung biopsies. Statistical analyses were performed using RevMan 5.4.1, and P .05 was considered statistically significant. Meta-regression was done by Open Meta-Analyst. Results Twelve studies were included in the meta-analysis, with a total of 1353 patients. The LACT biopsy group was associated with significantly higher first-puncture success (RR = 2.47, 95% CI: 1.44-4.23, P = 0.001), fewer CT scan and needle adjustment requirements (MD = -1.50, 95% CI: -2.08 to -0.91, P 0.00001), shorter procedure duration (MD = -7.69 min, 95% CI: -9.75 to -5.64, P 0.00001), and shorter intraoperative time (P 0.00001). LACT also had a significantly lower complications rate (pneumothorax, hemorrhage, and hemoptysis). Meta-regression indicated that increasing age was associated with a higher risk of pneumothorax (P = 0.022). Conclusions LACT lung biopsies improve first-puncture success, diagnostic accuracy, efficiency, and safety compared with the conventional approach. However, further RCTs with good quality and standardized protocols are required to address these potential biases. Implications These findings indicate that LACT has the potential to be incorporated into clinical practice for diagnosing lung nodules, given its association with reduced procedure time, fewer punctures, and lower complication risk, thereby providing benefits for both patients and operators. This abstract is funded by: none.
Hasson et al. (2026) studied this question.