Management of Pneumothorax After Percutaneous CT-Guided Lung Biopsy

Yamagami, Takuji; Nakamura, Toshiyuki; Iida, Shigeharu; Kato, Takumi; Nishimura, Tsunehiko

doi:10.1378/chest.121.4.1159

Cited by 68 publications

(49 citation statements)

References 21 publications

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“…In our study, the most frequent complication was pneumothorax in both groups (Monopty group, 44.0%; Temno group, 48.3%), which is similar to those in previous reports [7,25,[26][27][28][29][30][31][32]. Also, the complication rates did not differ significantly between procedures using these two needles and were similar to those in previous reports of lung biopsy.…”

Section: Discussionsupporting

confidence: 91%

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Comparison of fully automated and semi-automated biopsy needles for lung biopsy under CT fluoroscopic guidance

Yoshimatsu

Yamagami²,

Tanaka³

et al. 2012

BJR

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Section: Discussionsupporting

confidence: 91%

“…The most common complication of CT scan-guided lung biopsy is pneumothorax, with a frequency ranging from 17.9% [25] to 54.3% [7,25,[26][27][28][29][30][31][32]. Haemoptysis is also well known as a biopsy-induced complication, with a frequency ranging from 2.0% [32] to 10.1% [6].…”

Section: Discussionmentioning

confidence: 99%

Comparison of fully automated and semi-automated biopsy needles for lung biopsy under CT fluoroscopic guidance

Yoshimatsu

Yamagami²,

Tanaka³

et al. 2012

BJR

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“…The most common complication of CT-guided lung biopsy is pneumothorax, with a frequency ranging from 17.9% [30] to 54.3% [34] according to previous reports [30,31,[41][42][43][44][45][46][47]. These reports reveal a frequency of chest tube placement ranging from 2.0% [43] to 15.0% [34] of all biopsy procedures.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of percutaneous lung biopsy using automated biopsy needles under CT-fluoroscopic guidance for ground-glass opacity lesions

Yamagami

Yoshimatsu²,

Miura³

et al. 2013

BJR

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Objective: The goal of our study was to evaluate the diagnostic performance of percutaneous lung biopsy under CT-fluoroscopic guidance for ground-glass opacity (GGO) lesions.Methods: 85 percutaneous needle lung biopsies were performed in 73 patients. Specimens were obtained by core biopsy utilising an automated cutting needle and were evaluated histologically. Final diagnosis was confirmed by independent surgical pathology, independent culture results or clinical follow-up.Results: Rates of adequate specimens obtained and of precise diagnosis by needle biopsy were 92.9% (79/85) and 90.6% (77/ 85) of evaluated lung lesions, respectively. Precise diagnosis was achieved in 87.1% (27/ 31) of lesions #10 mm in diameter, 90.0% (36/40) of lesions .10 mm to #20 mm and 100.0% (14/14) of lesions .20 mm. Precision in diagnosing GGO lesions according to the GGO component was 73.9% (17/23) for pure GGO lesions and 96.8% (60/62) for part-solid GGO lesions. Obtaining a precise diagnosis did not differ significantly according to the lesion size (p50.3840), but differences were significant according to the GGO component (p50.0047). Malignancy was accurately diagnosed in 35 of 36 malignant lesions for which surgery was later performed. The

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“…Eight risk factors of pneumothorax were used for the univariate and multivariate analysis based on the literature (16,(26)(27)(28)(29)(30) and clinical experience as follows: (I) patient: age, sex, and history of emphysema; (II) lesion: size [shortaxis diameter: measured with a lung window width of 1,600 Hounsfield units (HU) and a window level of −600 HU], depth (the depth of normal lung tissue along the needle path and contact between the lesion and the pleura); (III) biopsy: body position (supine, prone, or lateral) and number of pleural punctures.…”

Section: Discussionmentioning

confidence: 99%

“…Pneumothorax is the most common complication of transthoracic percutaneous needle biopsy, with a frequency of 24.0% to 59.6%, whereas the incidence of pneumothorax requiring chest tube drainage ranges from 2.2% to 14.2% (15,26,27,29,31,32). A large pneumothorax leads to lung collapse, and the risk to patients increases significantly when this occurs in an outpatient setting.…”

Section: Discussionmentioning

confidence: 99%

Logistic regression analysis and a risk prediction model of pneumothorax after CT-guided needle biopsy

Zhao¹,

Wang²,

Wang³

et al. 2017

J. Thorac. Dis.

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Background: Pneumothorax is the most common complication of computed tomography (CT)-guided needle biopsy. The purpose of this study was to investigate independent risk factors of pneumothorax, other than emphysema, after CT-guided needle biopsy and to establish a risk prediction model. Methods: A total of 864 cases of CT-guided needle biopsy with an 18-gauge cutting needle were enrolled in this study. The relevant risk factors associated with pneumothorax included age, sex, emphysema, shortaxis size of the lesion, depth of the lesion, body position, and the number of pleural punctures. Several independent risk factors of pneumothorax were found, and a predictive model for pneumothorax was established using univariate and multivariate logistic regression analyses. Results: Pneumothorax occurred in 31.4% (271/864) of cases. Univariate analysis showed that significant risk factors of pneumothorax included age, emphysema, small lesion size, no contact between the lesion and the pleura, prone or lateral body position, and multiple punctures. Independent risk factors of pneumothorax in the multivariate logistic regression analysis included emphysema (P=0.000), no contact between the lesion and the pleura (P=0.000), prone or lateral body position (P=0.002), and the number of pleural punctures (P=0.000). The sensitivity, specificity, and accuracy of the predictive model for pneumothorax were 56.8%, 79.6%, and 72.5%, respectively. Conclusions: Pneumothorax is a common complication of CT-guided lung biopsy. Independent risk factors of pneumothorax include emphysema, no contact between the lesion and the pleura, and prone or lateral body position. The predictive model developed in this study was highly accurate in predicting the incidence of pneumothorax.

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Management of Pneumothorax After Percutaneous CT-Guided Lung Biopsy

Cited by 68 publications

References 21 publications

Comparison of fully automated and semi-automated biopsy needles for lung biopsy under CT fluoroscopic guidance

Comparison of fully automated and semi-automated biopsy needles for lung biopsy under CT fluoroscopic guidance

Diagnostic performance of percutaneous lung biopsy using automated biopsy needles under CT-fluoroscopic guidance for ground-glass opacity lesions

Logistic regression analysis and a risk prediction model of pneumothorax after CT-guided needle biopsy

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