Associations between Covariates and Pneumothorax Observations in CT-Guided Lung Biopsies

Maalouf, Nour; Lavric, Daniela; Vasileva, Lora; Lamadé, Wolfram; Apitzsch, Jonas

doi:10.3390/jcm11071958

Cited by 2 publications

(2 citation statements)

References 25 publications

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“…All procedures were performed by the same operator. Various previous studies have evaluated the importance of the needle-pleura angle and its significance in the incidence of pneumothorax [3,6,[9][10][11]. A multivariate analysis by Hiraki et al involving 1098 patients found that a needle trajectory angle of <45 • (p = 0.014) was a significant risk factor for pneumothorax [9].…”

Section: Discussionmentioning

confidence: 99%

“…Several recent studies have highlighted the significance of the needle's angle in the pleura and the relationship between the right angle and the incidence of pneumothorax [4,6]. This paper aims to correlate the frequency and severity of pneumothorax to different needlepleura angles, allowing the operator to guide the needle through a safe zone with a lower risk of pneumothorax.…”

Section: Introductionmentioning

confidence: 99%

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Safe Zone to Avoid Pneumothorax in a CT-Guided Lung Biopsy

Maalouf¹,

Mrad

Lavric³

et al. 2023

JCM

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Pneumothorax is one of the most frequent complications of computed tomography (CT)-guided lung biopsies. We aim to identify the safe zone of the needle–pleura angle during a CT-guided lung biopsy. Fifty-two patients underwent CT-guided lung biopsies between January 2020 and September 2022 (27 males, 25 females, median age 70 years). Right and left needle angles were measured and correlated to the incidence of pneumothorax. The minimum delta (δmin) was calculated as the absolute value of the difference between a 90° angle and the right and left angles. t-test p-values for δmin were conducted. We recorded 29 patients with pneumothorax, including intraprocedural and transient, postprocedural with minimal symptoms, or postprocedural requiring a chest tube insertion. Thirty-two patients had a δmin ≥ 10°, while 20 had a δmin < 10°. Of the patients with a δmin < 10°, 30% experienced pneumothorax compared to 71.8% in patients with δmin ≥ 10° (p = 0.0023). The study results show that as the needle’s angle deviates from the perpendicular, with an absolute value of more than 10°, the likelihood of pneumothorax increases significantly. A needle–pleura angle between 80° and 100° gives the operator a safe zone to reduce the risk of pneumothorax.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safe Zone to Avoid Pneumothorax in a CT-Guided Lung Biopsy

Maalouf¹,

Mrad

Lavric³

et al. 2023

JCM

Self Cite

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The nodule-pleura relationship affects pneumothorax in CT-guided percutaneous transthoracic needle biopsy: avoiding to cross pleural tail sign may reduce the incidence of pneumothorax

Deng,

Xie,

Zhu

et al. 2024

BMC Pulm Med

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Objectives To explore the role of nodule-pleural relationship, including nodule with pleural tail sign (PTS), nodule with pleural contact and nodule with pleural unrelated in CT-guided percutaneous transthoracic needle biopsy (PTNB)-induced pneumothorax, and whether employing different puncture routes has an impact on the incidence of pneumothorax in PTNB of nodules with PTS. Methods Between April 1, 2019, to June 30, 2021, 775 consecutive PTNB procedures of pulmonary nodules in the Peking University Cancer Hospital were retrospectively reviewed. The univariate and multivariate regression analysis were used to identify the risk factors for pneumothorax in PTNB. Results The nodule with pleural contact group has a lower incidence of pneumothorax than the nodule with PTS group ( p = 0.001) and the nodule with pleural unrelated group ( p = 0.002). It was observed that a higher incidence of pneumothorax caused by crossing PTS compared with no crossing PTS ( p < 0.001). Independent risk factors for pneumothorax included crossing PTS ( p < 0.001), perifocal emphysema ( p < 0.001), biopsy side up ( p < 0.001), longer puncture time ( p < 0.001), deeper needle insertion depth (intrapulmonary) ( p < 0.001) and nodules in the middle or lower lobe ( p = 0.007). Conclusion Patients with crossing PTS, a nodule in the middle or lower lobe, longer puncture time, biopsy side up, deeper needle insertion depth (intrapulmonary), and perifocal emphysema were more likely to experience pneumothorax in PTNB. When performing the biopsy on a nodule with PTS, selecting a route that avoids crossing through the PTS may be advisable to reduce the risk of pneumothorax. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-024-03307-z.

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Associations between Covariates and Pneumothorax Observations in CT-Guided Lung Biopsies

Cited by 2 publications

References 25 publications

Safe Zone to Avoid Pneumothorax in a CT-Guided Lung Biopsy

Safe Zone to Avoid Pneumothorax in a CT-Guided Lung Biopsy

The nodule-pleura relationship affects pneumothorax in CT-guided percutaneous transthoracic needle biopsy: avoiding to cross pleural tail sign may reduce the incidence of pneumothorax

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