Percutaneous transthoracic lung biopsy is thought to have been developed by Leyden in 1883 in order to diagnose pneumonia. The technique was extended to the diagnosis of cancer from the 1930s onwards, but at that time there was a significant complication rate, primarily associated with the use of large bore needles. The more widespread use of the technique in the 1960s and 1970s was heralded by the development of high resolution image intensification and improved cytological techniques, which permitted the use of smaller needles and reduced complications. One hundred and twenty years after its inception, percutaneous lung biopsy is now a generally accepted and widely used method of establishing the aetiology of lung masses.

Despite its usefulness, the procedure is not without its morbidity and rarely mortality. It was one of these rare deaths that prompted a search for current standards of good practice. A survey published in 2002 by Richardson et al,¹ in which all known centres performing lung biopsy in the United Kingdom were invited to participate, showed that practice varied greatly across the country. Some centres reported undertaking as few as three biopsies a year and others over 200. There appeared to be …