Objectives—The objective was to compare the effectiveness of observation in standard-of-care computed tomography (CT) in adult patients with suspected acute appendicitis (AA). Methods—Patients with clinically suspected AA and inconclusive diagnosis after primary clinical examination, laboratory examination, and transabdominal ultrasound (TUS) were eligible for the study, and they were randomized (1:1) to parallel groups: observation-group patients were observed for 8–12 h and then, repeated clinical and laboratory examinations and TUS were performed; CT group (control group) patients underwent abdominopelvic CT scan. The study utilized Statistical Analysis System 9.2 for data analysis, including tests, logistic regression, ROC analysis, and significance evaluation. Patients were enrolled in the study at Vilnius University Hospital Santaros Klinikos in Lithuania between December 2018 and June 2021. Results—A total of 160 patients (59 men, 101 women), with a mean age of 33.7 ± 14.71, were included, with 80 patients in each group. Observation resulted in a reduced likelihood of a CT scan compared with the CT group (36.3% vs. 100% p < 0.05). One diagnostic laparoscopy was performed in the observation group; there were no cases of negative appendectomy (NA) in the CT group. Both conditional CT and observation pathways resulted in high sensitivity and specificity (97.7% and 94.6% vs. 96.7% and 95.8%). Conclusions—Observation including the repeated evaluation of laboratory results and TUS significantly reduces the number of CT scans without increasing NA numbers or the number of complicated cases.

Background/Objectives: CT-guided transthoracic lung biopsy is a broadly performed and minimally invasive procedure for obtaining tissue samples from pulmonary lesions, offering a high diagnostic yield, and remains a cornerstone of accurate lung cancer diagnosis. The primary objective of this study was to assess the diagnostic yield of CT-guided transthoracic lung biopsies and to investigate the factors influencing this yield, with procedure-related complications being a secondary objective. Methods: A retrospective study was conducted on 356 CT-guided transthoracic lung biopsies performed between January 2021 and December 2023. The patient demographics, lesion characteristics (size, location) and histological findings were analyzed. The diagnostic yield was evaluated based on histological findings and, if necessary, follow-up information. Results: Of the 356 biopsies, 326 (91.6%) were found to be diagnostic, and 30 (8.4%) were non-diagnostic. The diagnostic yield was significantly influenced by lesion size and the number of biopsy cores, with lesions ≤2 cm associated with a higher diagnostic failure rate (p = 0.034). A significant interaction was also observed between lesion size and core number (p < 0.001). The overall complication rate was 11.5%, with pneumothorax being the most frequent event (7.0%). CIRSE grade 2 and grade 3 complications occurred in 4.8% and 3.1% of cases, respectively. Solid lesion morphology was identified as an independent predictor of complications (OR = 1.67, p = 0.022). Conclusions: In summary, CT-guided transthoracic lung biopsy demonstrates a high diagnostic yield with an acceptable safety profile and remains an important diagnostic tool in the evaluation of pulmonary lesions.