Chest Computed Tomography (CT) Immediately after CT-Guided Transthoracic Needle Aspiration Biopsy as a Predictor of Overt Pneumothorax

Noh, Tae June; Lee, Chang Hoon; Kang, Young Ae; Kwon, Sung Youn; Yoon, Ho Il; Kim, Tae Jung; Lee, Kyungwon; Lee, Jae Ho; Lee, Choon Taek

doi:10.3904/kjim.2009.24.4.343

Cited by 12 publications

(11 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, pneumothorax developed in 30% of CTLB procedures, comparable to previous studies [9,20]. Of all cases of pneumothorax, 16.1% was delayed occurrence.…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Pneumothorax after CT-guided transthoracic lung biopsy: A comparison between immediate and delayed occurrence

Bae

Jeon

2020

PLoS ONE

View full text Add to dashboard Cite

Background In CT-guided transthoracic lung biopsy (CTLB), pneumothorax can occur as a late complication (delayed pneumothorax). The incidence, risk factors, and clinical significance of delayed pneumothorax are not well known. Objectives To compare the risk factors for immediate and delayed pneumothorax after CTLB and to know their clinical significance. Methods Images and medical records of 536 consecutive patients who underwent CTLB were reviewed. All biopsies were performed as inpatient procedures. Follow-up chest radiographs were obtained at least twice at 4 h after procedure and before discharge. Risk factors for immediate and delayed pneumothorax were assessed based on patient-, lesion-, and procedure-related variables. Rates of chest tube insertion were also compared. Results Pneumothorax developed in 161 patients (30.0%) including 135 (25.2%) immediate and 26 (4.9%) delayed cases. Lesion size was an independent risk factor for both immediate and delayed pneumothorax (OR = 0.813; CI = 0.717-0.922 and OR = 0.610; CI = 0.441-0.844, respectively). While emphysema, lower lobe location, and long intrapulmonary biopsy track were risk factors (

show abstract

“…In the present study, pneumothorax developed in 30% of CTLB procedures, comparable to previous studies [9,20]. Of all cases of pneumothorax, 16.1% was delayed occurrence.…”

Section: Discussionsupporting

confidence: 91%

“…Of all cases of pneumothorax, 16.1% was delayed occurrence. In other studies involving delayed pneumothorax, the proportion ranged from 7.1% to 29.6% of the overall rate of pneumothorax [17][18][19][20][21].…”

Section: Discussionmentioning

confidence: 87%

Pneumothorax after CT-guided transthoracic lung biopsy: A comparison between immediate and delayed occurrence

Bae

Jeon

2020

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…In a comparative study between immediate CT scans and follow-up chest radiography after TFNAB, Noh et al reported that the overall incidence of delayed pneumothorax was 2.6% [13]. In our study, the incidence of delayed pneumothorax was 1.1% (1/94 procedures).…”

Section: Discussionmentioning

confidence: 49%

Transthoracic fine-needle aspiration biopsy of the lungs using a C-arm cone-beam CT system: diagnostic accuracy and post-procedural complications

Lee

Chong²,

Seo³

et al. 2012

BJR

View full text Add to dashboard Cite

Objective: The purpose of our study was to evaluate the diagnostic accuracy of transthoracic fine-needle aspiration biopsy (TFNAB) using a C-arm cone-beam CT (CBCT) system and to assess risk factors for immediate post-procedural complications in patients with lung lesions. Methods: From October 2007 to April 2009, 94 TFNAB procedures using a C-arm system were studied in 91 patients with pulmonary lesions a chest CT scans. We retrospectively reviewed the patients' radiological and histopathological findings. We evaluated the lesion size, lesion abutted to pleura and presence or absence of emphysema along the needle path, lesion depth, visibility of target lesion and patient's position. Pneumothorax and pulmonary haemorrhage were assessed after TFNAB. Overall diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were analysed. Results: In 94 TFNAB procedures, 58 lesions were malignant and 36 were benign. The sensitivity, specificity, PPV, NPV and overall diagnostic accuracy rate of TFNAB were 93.1%, 100%, 100%, 90% and 97.9%, respectively. Pneumothorax was developed in 24 procedures. None of the parameters showed significant impact on the frequency of the pneumothorax. Overall haemorrhage occurred in 43 procedures. The incidence of overall haemorrhage was higher in patients with smaller lesions, longer pleural distance and pleural abutted lesions (p,0.05). Differences in visibility at projection radiographs were statistically significant between patients with or without perilesional haemorrhage (p,0.05). Conclusion: Transthoracic fine-needle aspiration biopsy using a C-arm CBCT system is feasible for imaging guidance of lung lesion and early detection of the proceduralrelated complications.

show abstract

“…This radiographically defined pneumothorax risk tends to be much higher than if pneumothorax were based on clinical criteria, or even chest x-ray. For example, Noh et al 18 contrasted the rate of pneumothorax observed by CT immediately post-biopsy (25%) with the much lower rate of pneumothorax identified by chest x-ray or clinical symptoms 4–16 hours after biopsy (12%). This “clinical” pneumothorax rate of 12% closely approximates the 15% risk of pneumothorax estimated by Wiener et al 4 Similarly, the median risk of pneumothorax requiring chest tube estimated based on the single-institution case series (4%) is similar to the 6% risk of pneumothorax requiring chest tube identified by Wiener et al in their multi-institution analysis.…”

Section: Resultsmentioning

confidence: 99%

Risks of Transthoracic Needle Biopsy

Wiener

Gould

2013

Clinical Pulmonary Medicine

View full text Add to dashboard Cite

Transthoracic needle lung biopsy is a commonly performed diagnostic procedure for pulmonary nodules and masses. To make an informed decision about whether to pursue this procedure, doctors and patients must be aware of the possible risks of the procedure. We performed a MEDLINE search, 2003–2012 to identify relevant English-language studies that included at least 100 subjects and reported data on complications of transthoracic needle lung biopsy performed within the last 10 years. We found the most common complication to be any pneumothorax (risk 15–25%), with pneumothorax requiring chest tube occurring less often (risk 4-6%). Hemorrhage, defined as radiographically visualized blood along the needle tract was common, but clinically significant hemorrhage was infrequent (~1%). Rare complications, including air embolism and tumor seeding of the biopsy tract, occurred in fewer than 1% of cases but were potentially serious. We summarize data on factors associated with complications, including patient age, COPD, lesion size and location, and number of punctures. We also provide data on techniques to mitigate severity of pneumothorax post-biopsy, such as rapid patient rollover, manual aspiration, and instillation of substances into the biopsy tract.

show abstract

Chest Computed Tomography (CT) Immediately after CT-Guided Transthoracic Needle Aspiration Biopsy as a Predictor of Overt Pneumothorax

Cited by 12 publications

References 18 publications

Pneumothorax after CT-guided transthoracic lung biopsy: A comparison between immediate and delayed occurrence

Pneumothorax after CT-guided transthoracic lung biopsy: A comparison between immediate and delayed occurrence

Transthoracic fine-needle aspiration biopsy of the lungs using a C-arm cone-beam CT system: diagnostic accuracy and post-procedural complications

Risks of Transthoracic Needle Biopsy

Contact Info

Product

Resources

About