Development of a risk prediction model of pneumothorax in percutaneous computed tomography guided transthoracic needle lung biopsy

Weon, JangHo; Robson, Scott; Chan, R.; Ussher, Simon

doi:10.1111/1754-9485.13187

Cited by 9 publications

(8 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Throughout the above condition, if the biopsy needle is inserted, there is a potential possibility that the pleura will tear, increasing the risk of an immediate pneumothorax. This is comparable to the relationship between the occurrence of pneumothorax and the biopsy needle penetrating through the lung’s emphysematous changes ( 28 , 29 ). (II) The needle penetrating PTS may cause an elongated and bigger pleural hole during the CT-LNB procedure and further tear the visceral pleura.…”

Section: Discussionsupporting

confidence: 63%

The risk of immediate pneumothorax after CT-guided lung needle biopsy: pleural tail sign as a novel factor

Peng¹,

Deng²,

Wang³

et al. 2023

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background: Pneumothorax is the most frequent complication in computed tomography (CT)-guided lung needle biopsy (CT-LNB) and generally appears immediately or within an hour after CT-LNB.Preventing pneumothorax after CT-LNB requires a preoperative evaluation of risk factors. This study investigated risk factors for the occurrence of immediate pneumothorax after CT-LNB.Methods: A total of 311 CT-LNB procedures were conducted for 290 patients (217 males and 73 females) with persistent solid or part-solid pulmonary lesions in this case-control study. We retrospectively evaluated immediate postbiopsy pneumothorax complications and associated risk factors. The possible risk factors for immediate pneumothorax were analyzed, including 12 parameters in demographics, radiological features, and procedural factors. Univariate and multivariate logistic regression analyses were used to investigate independent risk factors for the occurrence of immediate pneumothorax after CT-LNB.Results: All CT-LNB procedures (100%) were technically successful. Immediate pneumothorax after CT-LNB occurred in 115 out of the 311 procedures (36.9%). Chest tube placement was required for 12.2% (14/115) of the pneumothoraces (14/311, 4.5% of the total number of CT-LNB procedures). The other pneumothoraces were treated conservatively. Independent risk factors of immediate pneumothorax included a lesion with pleural tail sign [PTS; odds ratio (OR) 3.021, 95% confidence interval (CI): 1.

show abstract

Section: Discussionsupporting

confidence: 63%

The risk of immediate pneumothorax after CT-guided lung needle biopsy: pleural tail sign as a novel factor

Peng¹,

Deng²,

Wang³

et al. 2023

Quant Imaging Med Surg

View full text Add to dashboard Cite

show abstract

“…The prediction score of PTLB complications is currently trending. [14][15][16][17][18][19][20] Both the retrospective studies by Anzidei et al and Iezzi et al presented a score predicting the occurrence of several complications, including pneumothorax. 14,15 Yang et al recently presented a predictive score for pneumothorax after a CT-guided co-axial core needle lung biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…The prediction score of PTLB complications is currently trending 14–20 . Both the retrospective studies by Anzidei et al and Iezzi et al presented a score predicting the occurrence of several complications, including pneumothorax 14,15 .…”

Section: Discussionmentioning

confidence: 99%

Score to Predict the Occurrence of Pneumothorax After Computed Tomography-guided Percutaneous Transthoracic Lung Biopsy

Lamfichekh,

Lafay,

Hamam

et al. 2023

Journal of Thoracic Imaging

View full text Add to dashboard Cite

Purpose: The main objective of this study was to identify risk factors for post-percutaneous transthoracic lung biopsy (PTLB) pneumothorax and to establish and validate a predictive score for pneumothorax occurrence to identify patients eligible for outpatient care. Material and Methods: Patients who underwent PTLB between November 1, 2012 and March 1, 2017 were retrospectively evaluated for clinical and radiologic factors potentially related to pneumothorax occurrence. Multivariate logistic regression was used to identify risk factors, and the model coefficient for each factor was used to compute a score. Then, a validation cohort was prospectively evaluated from March 2018 to October 2019. Results: Among the 498 eligible patients in the study cohort, pneumothorax occurred in 124 patients (24.9%) and required drainage in 34 patients (6.8%). Pneumothorax risk factors were chronic obstructive pulmonary disease (OR 95% CI 2.28[1.18–4.43]), several passages through the pleura (OR 95% CI 7.71[1.95–30.48]), an anterior biopsy approach (OR 95% CI 6.36 3.82–10.58]), skin-to-pleura distance ≤30 mm (OR 95% CI 2.25[1.09–6.65]), and aerial effusion >10 mm (OR 95% CI 9.27 [5.16–16.65]). Among the 236 patients in the prospective validation cohort, pneumothorax occurred in 18% and 8% were drained. A negative score (<73 points) predicted a probability of pneumothorax occurrence of 7.4% and late evacuation of 2.5% (OR 95% CI respectively 0.18[0.08–0.39] and 0.15[0.04–0.55]) and suggested a reduced length of hospital stay (P=0.009). Conclusion: This predictive score for pneumothorax secondary to PTLB has high prognostic performance and accuracy to direct patients toward outpatient management. Clinical Trials: NCT03488043

show abstract

“…The factors associated with pneumothorax have been investigated in several previous studies. Emphysema, lesion size, lesion location, patient position, insertion through the interlobar fissures, needle path length from the pleura to the lesion, skin-to-pleura distance, and age have been predictors of pneumothorax in several studies (11)(12)(13)(14)(15)(16). Pleural thickening, lobulation signs (16), lesions not in contact with the pleura (12,15), longer procedure duration, repositioning of a coaxial needle with new insertion through the pleura (17), and the use of a 19-G needle are predictors of pneumothorax (9) in other studies.…”

Section: Introductionmentioning

confidence: 99%

“…Biopsy methods vary among studies and even within studies, such as coaxial or non-coaxial, the use of core or fine needle biopsy, and the caliber of the biopsy needle. A few studies have further established prediction models for pneumothorax after CT-guided CCNB (12)(13)(14)(15)(16), and some of them have applied nomograms to visualize the results; however, the models have not been validated in their studies. One study further assessed the clinical usefulness of a predictive model using decision curve analysis (DCA), but some risk factors, such as emphysema, were not included in this study (14).…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a prediction model of pneumothorax after CT-guided coaxial core needle lung biopsy

Zhao¹,

Bao²,

Wu³

et al. 2022

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background: Pneumothorax is the most common complication of computed tomography-guided coaxial core needle biopsy (CCNB) and may be life-threatening. We aimed to evaluate the risk factors and develop a model for predicting pneumothorax in patients undergoing computed tomography-guided CCNB, and to further determine its clinical utility. Methods: Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for pneumothorax from 18 variables. A predictive model was established using multivariable logistic regression and presented as a nomogram based on a training cohort of 690 patients who underwent computed tomography-guided CCNB. The model was validated in 253 consecutive patients in the validation cohort and 250 patients in the test cohort. The area under the curve was used to determine the predictive accuracy of the proposed model. Results: The risk factors associated with pneumothorax after computed tomography-guided CCNB were sex, patient position, lung field, lesion contact with the pleura, lesion size, distance from the pleura to the lesion, presence of emphysema adjacent to the biopsy tract, and crossing fissures. The predictive model that incorporated these predictors showed good predictive performance in the training cohort [area under the curve, 0.71 (95% confidence interval: 0.67-0.75)], validation cohort [0.71 (0.64-0.78)], and internal test cohort [0.68 (0.60-0.75)]. The nomogram also provided excellent calibration and discrimination, and decision curve analysis (DCA) demonstrated its clinical utility.Conclusions: The predictive model showed good performance for pneumothorax after computed tomography-guided CCNB and may help improve individualized preoperative prediction.

show abstract

Development of a risk prediction model of pneumothorax in percutaneous computed tomography guided transthoracic needle lung biopsy

Cited by 9 publications

References 24 publications

The risk of immediate pneumothorax after CT-guided lung needle biopsy: pleural tail sign as a novel factor

The risk of immediate pneumothorax after CT-guided lung needle biopsy: pleural tail sign as a novel factor

Score to Predict the Occurrence of Pneumothorax After Computed Tomography-guided Percutaneous Transthoracic Lung Biopsy

Development and validation of a prediction model of pneumothorax after CT-guided coaxial core needle lung biopsy

Contact Info

Product

Resources

About