Transthoracic needle biopsy: factors effecting risk of pneumothorax

Topal, Uğur; Ediz, Bülent

doi:10.1016/s0720-048x(03)00058-5

Cited by 87 publications

(64 citation statements)

References 16 publications

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“…In our study, pneumothorax occurred in 36% of cases, which is a slightly higher rate than those (19-30%) reported in recent reports [18][19][20][21]. This may be caused by differences in biopsy techniques.…”

Section: Discussioncontrasting

confidence: 65%

Value of high-resolution ultrasound in detecting a pneumothorax

Chung

Goo

et al. 2004

Eur Radiol

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This study was designed to compare the detectability of high-resolution ultrasound (HRUS) and bedside chest radiography (CR) for a pneumothorax. During the last 14 months, 97 consecutive patients who were admitted to our institute to undergo a transthoracic needle aspiration and biopsy (TNAB) of the lung were included. Both HRUS and CR were performed immediately after the TNAB procedure. The HRUS images were saved in sequence using the cine-review mode and displayed as an animation on a workstation. Four radiologists independently analyzed both HRUS images and a soft copy of the CR on a diagnostic monitor and identified the pneumothorax. With CT as the reference standard, statistical parameters were calculated. From 97 patients, 35 pneumothorax cases were found on CT after the TNAB. The sensitivities in detecting the pneumothorax were 80 and 47% in HRUS and CR, respectively. The specificities were 94 and 94%. The diagnostic accuracies were 89 and 77%. The inter-observer agreement was excellent (kappa=0.85) in the HRUS images and moderate (kappa=0.49) in the CR. The results of this study suggest that HRUS is a more sensitive and confident method for diagnosing a pneumothorax when compared to bedside chest radiography.

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Section: Discussioncontrasting

confidence: 65%

Value of high-resolution ultrasound in detecting a pneumothorax

Chung

Goo

et al. 2004

Eur Radiol

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“…18 The estimated chance of developing a pneumothorax after transthoracic needle biopsy ranges from 20% to 50%. [27][28][29][30][31] Both emphysema and the amount of aerated lung tissue to be traversed during biopsy are risk factors for pneumothorax, and both risk factors were present in most of our patients, which increased the risk of a clinically relevant pneumothorax in these single-lung patients. Because the reported complication rate associated with SRT is much lower than the life-threatening complications that accompany a pneumothorax in postpneumonectomy patients, either the referring physicians and/or the patients who were treated in our series declined transthoracic biopsies before referral for SRT.…”

Section: Discussionmentioning

confidence: 80%

Outcomes of stereotactic radiotherapy for a new clinical stage I lung cancer arising postpneumonectomy

Haasbeek

Lagerwaard

Jaeger

et al. 2009

Cancer

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BACKGROUND:Resection of second primary lung tumors that arise after previous pneumonectomy is associated with a high risk of complications. In this study, the authors reviewed outcomes after stereotactic radiation therapy (SRT) for such patients.METHODS:SRT was undergone by 15 patients who developed a new clinical stage I lung cancer at a median of 8.9 years postpneumonectomy, half of whom had severe chronic obstructive pulmonary disorder (COPD). SRT target volumes encompassed all respiratory motion using 4‐dimensional computed tomography (CT) scans, and risk‐adapted radiation schemes that ranged from 3 × 20 grays (Gy) to 8 × 7.5 Gy were used, depending on tumor size, location, and overlap with prior radiation treatment. All schemes had a biologic effective dose >100 Gy. Follow‐up CT scans were obtained at 3 months, 6 months, and 12 months after SRT and yearly thereafter.RESULTS:At a median follow‐up of 16.5 months, no local failures were observed, and only 2 patients experienced grade ≥3 toxicity. One patient had transient pneumonitis that required steroids, and another patient required an increase in oxygen use. The 1‐year actuarial disease‐free survival rate was 92%. One patient died 10 months post‐SRT after developing regional and distant metastases, and 1 patient developed an isolated regional failure. All other patients remained alive and disease free.CONCLUSIONS:SRT was a safe and effective treatment for stage I lung tumors that arose after prior pneumonectomy, even in patients who had severe COPD. SRT was tolerated well, and the current findings suggest that surveillance for second tumors is indicated in all patients after pneumonectomy. Cancer 2009. © 2009 American Cancer Society.

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“…Various investigators have analyzed factors thought to affect the diagnostic accuracies and complication rates for CT-guided lung biopsy (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Risk factors for the development of pulmonary lung biopsy-associated pneumothorax include age, smoking history, lesion volume, lesion position, depth from the pleura to the tumor, biopsy needle angle, and needle thickness (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Operator experience is also a risk factor (17).…”

Section: Introductionmentioning

confidence: 99%

Computed tomography‑guided lung biopsy: Association between biopsy needle angle and pneumothorax development

et al. 2017

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Abstract. Computed tomography (CT)-guided lung biopsy is a well-established diagnostic method for pulmonary lesions. However, the use of this technique often results in pneumothorax development. The aim of the present study was to evaluate the association between biopsy needle angle and pneumothorax development associated with computed tomography-guided lung biopsy. We retrospectively analyzed the results of CT-guided lung biopsies for 325 cases to investigate physical risk factors for pneumothorax development. Biopsy needle angle and patient positioning were included in the analysis. Pneumothorax occurred in 160 of 325 procedures (49.2%). Discontinuation of the procedure as a result of pneumothorax occurred in 18 of 160 procedures (11.2%). Upper lung lobe pneumothorax occurred in 40.8% (58/142), middle lobe in 17.6% (25/142), and lower lobe pneumothorax occurred in 41.5% (59/142) of these procedures. Discontinuation of the procedure occurred in 2.5% of the upper lobe (4/160), 0.6% of the middle lobe (1/160), and 8.1% of the lower lobe (13/160) biopsies. Mild pneumothorax occurred in 59.4% (95/160), moderate in 25.0% (40/160), and severe in 7.5% (12/160) of the affected cases, and biopsy was discontinued in 11.2% (18/160) of the affected cases. When the needle angle was <90˚, 40.3% (131/325) of the patients experienced no pneumothorax development, 40.0% (130/325) developed pneumothorax, and 4.3% (14/325) of the procedures were discontinued. The results showed that use of CT-guided lung biopsy can reduce the rate of pneumothorax development that occurs when other procedures are used. The access route is simple and easy to puncture, and proper use of breath holding reduces diaphragmatic movement.

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Transthoracic needle biopsy: factors effecting risk of pneumothorax

Cited by 87 publications

References 16 publications

Value of high-resolution ultrasound in detecting a pneumothorax

Value of high-resolution ultrasound in detecting a pneumothorax

Outcomes of stereotactic radiotherapy for a new clinical stage I lung cancer arising postpneumonectomy

Computed tomography‑guided lung biopsy: Association between biopsy needle angle and pneumothorax development

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