Risk factors of pneumothorax and chest tube placement after computed tomography-guided core needle biopsy of lung lesions: A single-centre experience with 822 biopsies

Kerem Ozturk, Esra Soylu, Gokhan Gokalp, Ugur Topal

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Purpose To determine the risk factors of pneumothorax and chest tube placement after computed tomography-guided core needle lung biopsy (CT-CNB). Material and methods Variables that could increase the risk of pneumothorax and chest tube placement were retrospectively analysed in 822 CT-CNBs conducted with 18-gauge non-coaxial CT-CNB in 813 patients (646 men and 167 women; range: 18-90 years; mean: 59.8 years). Predictor variables were age, gender, patient position, severity of pulmonary emphysema, lesion size and localisation, contour characteristics, presence of atelectasis, pleural tag and fissure in the needle-tract, length of the aerated lung parenchyma crossed by the needle, needle entry angle, number of pleural punctures, experience of the operator, and procedure duration. All variables were investigated by ×2 test and logistic regression analysis. Results The overall incidence of pneumothorax was 15.4% (127/822). Chest tube placement was required for 22.8% (29/127) of pneumothoraxes. The significant independent variables for pneumothorax were lesions smaller than 3 cm (p = 0.009), supine and lateral decubitus position during the procedure (p <0.001), greater lesion depth (p = 0.001), severity of pulmonary emphysema (p <0.001), needle path crossing the fissure (p <0.001), and a path that skips the atelectasis (p <0.001) or pleural tag (p <0.001); those for chest tube placement were prone position (p <0.001), less experienced operator (p = 0.001), severity of pulmonary emphysema (p <0.001), and greater lesion depth (p = 0.008). Conclusions The supine and lateral decubitus position, a needle path that crosses the fissure, and a path that skips the atelectasis or a pleural tag are novel predictors for the development of pneumothorax.
Original languageEnglish (US)
Pages (from-to)e407-e414
JournalPolish Journal of Radiology
Volume83
DOIs
StatePublished - 2018

Keywords

  • CT-guided core needle lung biopsy (CT-CNB)
  • Chest tube
  • Computed tomography (CT)
  • Pneumothorax
  • Pulmonary lesion

PubMed: MeSH publication types

  • Journal Article

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