M Mills1, J Choi1, G El-Haddad1, J Sweeney1, B Biebel1, L Robinson2, S Antonia2, A Kumar3, B Kis4. 1. Division of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, FL, USA. 2. Division of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA. 3. Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA. 4. Division of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, FL, USA. Electronic address: bela.kis@moffitt.org.
Abstract
AIM: To investigate the technical success rate and procedure-related complications of computed tomography (CT)-guided needle biopsy of lung lesions and to identify the factors that are correlated with the occurrence of procedure-related complications. MATERIALS AND METHODS: This was a single- institution retrospective study of 867 consecutive CT-guided needle biopsies of lung lesions performed on 772 patients in a tertiary cancer centre. The technical success rate and complications were correlated with patient, lung lesion, and procedure-related variables. RESULTS: The technical success rate was 87.2% and the mortality rate was 0.12%. Of the 867 total biopsies 25.7% were associated with pneumothorax, and 6.5% required chest tube drainage. The haemothorax rate was 1.8%. There was positive correlation between the development of pneumothorax and smaller lesion diameter (p<0.001), longer transparenchymal distance (p<0.001), and prone position (p=0.027). There was positive correlation between the need for chest tube placement and longer transparenchymal distance (p=0.007) and smaller lesion diameter (p=0.018). Lesions in the left lower lobe had the lowest rates of pneumothorax (p=0.008) and chest tube drainage (p=0.018). Patients whose pneumothoraces were diagnosed on the follow-up chest X-ray, but not on the immediate post-procedural CT scan had significantly higher requirement for chest tube drainage (p=0.039). CONCLUSION: CT-guided lung biopsy has a high rate of technical success and a low rate of major complications. The present study has revealed several variables that can be used to identify high-risk procedures. A post-procedural chest X-ray within hours after the procedure is highly recommended to identify high-risk patients who require chest tube placement.
AIM: To investigate the technical success rate and procedure-related complications of computed tomography (CT)-guided needle biopsy of lung lesions and to identify the factors that are correlated with the occurrence of procedure-related complications. MATERIALS AND METHODS: This was a single- institution retrospective study of 867 consecutive CT-guided needle biopsies of lung lesions performed on 772 patients in a tertiary cancer centre. The technical success rate and complications were correlated with patient, lung lesion, and procedure-related variables. RESULTS: The technical success rate was 87.2% and the mortality rate was 0.12%. Of the 867 total biopsies 25.7% were associated with pneumothorax, and 6.5% required chest tube drainage. The haemothorax rate was 1.8%. There was positive correlation between the development of pneumothorax and smaller lesion diameter (p<0.001), longer transparenchymal distance (p<0.001), and prone position (p=0.027). There was positive correlation between the need for chest tube placement and longer transparenchymal distance (p=0.007) and smaller lesion diameter (p=0.018). Lesions in the left lower lobe had the lowest rates of pneumothorax (p=0.008) and chest tube drainage (p=0.018). Patients whose pneumothoraces were diagnosed on the follow-up chest X-ray, but not on the immediate post-procedural CT scan had significantly higher requirement for chest tube drainage (p=0.039). CONCLUSION: CT-guided lung biopsy has a high rate of technical success and a low rate of major complications. The present study has revealed several variables that can be used to identify high-risk procedures. A post-procedural chest X-ray within hours after the procedure is highly recommended to identify high-risk patients who require chest tube placement.
Authors: Kyoungmin Lee; So Jung Lee; Shinkyo Yoon; Baek-Yeol Ryoo; Sang-We Kim; Sang Hyun Choi; Sang Min Lee; Eun Jin Chae; Yangsoon Park; Se-Jin Jang; Soo-Yeon Park; Young-Kwang Yoon; Seong Ho Park; Tae Won Kim Journal: PLoS One Date: 2019-08-12 Impact factor: 3.240