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Abstract Image guided transthoracic needle biopsy is an integral tool used for the diagnosis of many thoracic diseases. Computed tomography (CT) is the most common imaging modality used for guidance followed by ultrasound (US) for lesions abutting the pleural surface (DiBardinoet al, 2015).CT-guided trans-thoracic needle biopsy allows for precise localization of the target lesion and any adjacent large vessels or bronchi and allows for determination of the optimal skin entry site. Additionally, CT provides for safe trans-thoracic needle biopsy of mediastinal lesions (Kanne, Jeffrey P, 2007).Ultrasound is a very reliable and efficient tool for evaluating lesions of the chest wall, pleural cavity, peri-diaphragm and peripheral lungs |