Global research trends and hotspots in CT‑guided percutaneous transthoracic needle biopsy: a bibliometric analysis

Every year, millions of people around the world are diagnosed with lung cancer, a disease that remains the leading cause of cancer-related death globally. When doctors find a suspicious spot on a lung scan, they must determine if it is cancer before they can decide on a treatment plan. To do this, they need a sample of the tissue. One of the most common ways to get that sample is a procedure called a CT-guided percutaneous transthoracic needle biopsy. In this process, a doctor uses a computerized tomography scanner, which creates detailed cross-sectional images of the body, to guide a thin needle through the chest wall and into the lung. It is a critical step that allows for an accurate diagnosis, but it is not without risks. The procedure can sometimes cause the lung to collapse or lead to bleeding, and as treatments become more personalized, doctors also need to ensure they collect enough tissue to test for specific genetic markers. Because this procedure is so vital yet carries inherent challenges, the medical community has spent the last decade and a half refining how it is done, studying its safety, and exploring new technologies to make it more effective.

A team of researchers from China recently took a step back to look at the entire global effort to improve this procedure. Instead of conducting a new experiment in a hospital, they performed a massive review of the scientific literature itself. They gathered 804 research papers published between 2010 and 2026 that focused specifically on this needle biopsy technique. Using specialized software designed to map out how ideas connect, they analyzed who was writing these papers, which countries were working together, and what topics were being discussed most frequently. Their goal was to create a clear picture of how the field has evolved, where the major breakthroughs have happened, and where the scientific community is heading next.

The analysis revealed that interest in this procedure has been steadily growing. While the number of published studies fluctuated slightly from year to year, the overall trend was upward, with a particularly high number of papers appearing in 2024. The research is a truly global effort, but the geography of who is doing the work is distinct. China produced the largest number of studies, followed by the United States and South Korea. However, the way these nations collaborate tells a different story. While East Asian countries are the most productive in terms of volume, Germany and the United States act as the central bridges, connecting different research groups across the world. In terms of specific institutions, Seoul National University in South Korea emerged as the most prolific center for this research, acting as a hub that connects many other teams.

When the researchers looked at what these studies were actually about, four main themes stood out as the driving forces of modern research. The first is simply making the diagnosis more accurate and the technique better. Scientists are constantly working to ensure that the needle hits the right spot, especially when the lung nodules are very small or have a hazy appearance on a scan. The second major focus is managing the risks. The most common complications are a collapsed lung and bleeding within the lung tissue. A significant portion of the literature is dedicated to predicting who is most likely to experience these problems and how to prevent them. The data shows that researchers are increasingly using complex models to identify patients with severe emphysema or specific lesion characteristics who are at higher risk, allowing doctors to take extra precautions before the needle even enters the body.

The third area of intense activity involves new technology that goes beyond just taking a picture. The field is moving toward advanced navigation systems, similar to a GPS for the body, which help guide the needle with greater precision. There is also a growing trend toward combining the biopsy with treatment. Instead of just taking a sample, doctors are increasingly using the same needle access point to perform thermal ablation, a technique that uses heat to destroy cancer cells. This shift represents a move from a purely diagnostic procedure to a "theranostic" approach, where diagnosis and treatment happen in a single session. The final major hotspot is the need for better tissue samples for genetic testing. As cancer treatment becomes more personalized, relying on a tiny sample is no longer enough. Researchers are refining their methods to ensure they collect sufficient material for advanced genetic analysis, which is essential for choosing the right targeted therapy for each patient.

The history of this research field, as traced by the authors, shows a clear evolution. In the early years, the focus was largely on the hardware: the type of needle, the cutting mechanism, and the basic mechanics of the procedure. Over time, the conversation shifted toward safety and risk management. More recently, the spotlight has turned toward integration and precision. The data suggests that the field is no longer just about how to stick a needle into a lung; it is about how to do so with maximum safety, minimum trauma, and maximum utility for the patient's long-term care. By mapping these trends, the researchers have provided a roadmap for the future, showing that the next generation of this procedure will likely be defined by its ability to navigate complex anatomy, prevent complications, and deliver the precise tissue samples needed for modern, personalized medicine.