CT guided lung biopsy: a lesion’s lobar location and distance from pleura as independent risk factors for pneumothorax

Hailemariam, Mengistu; Petrov, Danail; Muzaffar, Nabeel; Vance, L.M.

doi:10.1016/j.jvir.2015.12.435

Cited by 2 publications

(1 citation statement)

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“…Hailemariam et al demonstrated that pneumothorax most commonly occurred in biopsies of middle lobe lesions (64.7%) as opposed to lower or upper lobe lesions (26.5% and 31.4%, respectively) ( P = .007) in a retrospective analysis of 289 CT-guided lung biopsies. [26] However, another retrospective study (201 fine-needle aspiration biopsies and 68 core biopsies) failed to prove a significant correlation between increased risk of pneumothorax and lesion location. [9] Furthermore, univariate analysis in a study with 141 small nodules punctures showed that the risk of CPLB-induced pneumothorax was approximately 3 times higher for upper lobe tumors than for nonupper lobe tumors ( P = .036), but multivariate analysis did not reveal a significant difference.…”

Section: Discussionmentioning

confidence: 99%

Lobar location of lesions in computed tomography-guided lung biopsy is correlated with major pneumothorax

Yan¹,

Guo²,

Zhang³

et al. 2019

Medicine

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Pneumothorax is a common complication in computed tomography (CT)-guided percutaneous lung biopsy (CPLB). Whether the lobar location of lesions contributes to the incidence of pneumothorax should be further clarified. A total of 1452 consecutive patients who underwent CPLB between January 2010 and March 2018 were retrospectively analyzed. The incidence of pneumothorax was compared among 5 different lobe biopsies. Minor pneumothorax was defined as pneumothorax without chest tube placement and major pneumothorax was defined as pneumothorax with chest tube placement. The positive diagnosis rate of pathology for this cohort was approximately 84%, with 22.5% (326/1452) of the patients experiencing pneumothorax. The rates of pneumothorax were 19.5%, 24.5%, 33.9%, 21.4%, and 23.9% for the right upper lobe, right lower lobe, right middle lobe, left upper lobe, and left lower lobe, respectively ( P = .09). Chest tube placement was necessary in 19.0% (62/326) of the patients with pneumothorax. The rates of major pneumothorax were 5.3%, 2.6%, 10.2%, 4.7%, and 2.6% for the right upper lobe, right lower lobe, right middle lobe, left upper lobe, and left lower lobe biopsies, respectively ( P = .02). This result was further confirmed by the propensity score-matching method. Moreover, 8.7% (127/1452) of the patients experienced puncture of fissure, the rates of which were 13.5%, 5%, 10.2%, 9.1%, and 4.3% for the right upper lobe, right lower lobe, right middle lobe, left upper lobe, and left lower lobe, respectively ( P < .001). Within the pneumothorax patient group, the rate of lobe fissure puncture (15.2%) was significantly lower in patients with minor pneumothorax than (51.6%) in those with major pneumothorax ( P < .001). Upper and middle lobe lesion biopsies show a significantly high rate of major pneumothorax, which may be due to more puncture of fissure. It is crucial to carefully distinguish the fissure around lesions and bypass it to avoid major pneumothorax.

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Section: Discussionmentioning

confidence: 99%