Computed Tomography Guided Transthoracic Lung Biopsy: Evaluating Risk Factors of Post-Procedure Pneumothorax- A Multivariate Analysis
-
Faiz Altaf Shera
,
Tahleel Altaf Shera
,
Omair Ashraf Shah
,
Irfan Robbani
,
Naseer Choh
,
Tariq Gojwari
,
Abdul Majeed Dar
,
Sonaullah Shah
Abstract
Respected Editors, The purpose of this study was to evaluate the incidence and risk factors of post-procedure pneumothorax after CT guided transthoracic lung biopsy. This study has not been published or sent for publication in any other journal by any of the authors.While many studies have evaluated this topic most of them are univariate analysis. This study utilizes multivariate logistic regression analysis to identify which of the risk factors are independent predictors of pneumothorax. Moreover this study has identified a novel risk factor of post procedure pneumothorax.-the lateral position of the patient during biopsy. This risk factor has scarcely been mentioned in literature previously and would definitely add to the current knowledge on the topic. Thank You.
1. Boskovic T, Stanic J, Zarogoulidis P et al. Pneumothorax after transthoracic needle biopsy of lung lesions under CT guidance. J Thorac Dis. 2014 March; 6(S1): p.
2. Wu CC, Maher MM, Shepard JO. Complications of CT-Guided Percutaneous Needle Biopsy of the Chest: Prevention and Management. AJR. 2011; 196: p. W678–W682
3. Fish GD , Stanley JH , Miller KS , Schabel SI , Sutherland SE. Postbiopsy Pneumothorax:Estimating the Risk by Chest Radiography and Pulmonary Function Tests. AJR. 1988; 150: p. 71–74.
4. Covey AM, Gandhi R , Brody LA, Getrajdman G, Thaler HT, Brown KT. Factors associated with pneumothorax and pneumothorax requiring treatment after percutaneous lung biopsy in 443 consecutive patients. J Vasc Interv Radiol. 2004; 15: p. 479–483.
5. Khan MF, Straub R, Moghaddam SR et al. Variables affecting the risk of pneumothorax and intrapulmonary hemorrhage in CT-guided transthoracic biopsy. Eur Radiol. 2008; 18: p. 1356–1363.
6. Haaga JR, Haaga TL , Wu H. Image Guided Interventions:CT emphasis. In Haaga J, Dogra V, Forsting M, Gilkeson R, Ha H, Sundaram M, editors. CT And MRI of the Whole Body. 5th ed. Philadelphia.USA.: Mosby.Elsevier.; 2009. p. 2462-2486.
7. Yamagami T, Nakamura T, Iida S , Kato T and Nishimura T. Management of Pneumothorax After Percutaneous CT-Guided Lung Biopsy. Chest. 2002; 121: p. 1159–1164
8.Yamagami T, Kato T, Iida S, Hirota T, Yoshimatsu R, Nishimura T. Efficacy of manual aspiration immediately after complicated pneumothorax in CT-guided lung biopsy. J Vasc Interv Radiol. 2005
9. YamagamiT,Terayama K, Yoshimatsu R , Matsumoto T ,Miura H , Nishimura T. Role of Manual Aspiration in Treating Pneumothorax after Computed Tomography-Guided Lung Biopsy. Acta Radiologica. 2009
10. Kakizawa H, Toyota N, Hieda M et al. Risk factors for severity of pneumothorax after CT-guided percutaneous lung biopsy using the single-needle method. Hiroshima J Med Sci. 2010 Sep; 59(3): p. 43-50.
11. Rizzo S, Preda L, Raimondi S et al. Risk factors for complications of CT-guided lung biopsies. Radiol Med. 2011 Jun; 116(4): p. 548-63.
12. Asai N, Kawamura Y, Yamazaki I et al. Is emphysema a risk factor for pneumothorax in CT-guided lung biopsy? Springerplus. 2013; 2: p. 196.
13. Zhang HF, Liao MY, Zhu DY, Chen J, Wang YF. Lung radiodensity along the needle passage is a quantitative predictor of pneumothorax after CT-guided percutaneous core needle biopsy. Clin Radiol. 2018 Mar; 73(3): p. 319.e1-319.e7.
14. Brown KT, Brody LA, Getrajdman GI ,Napp TE. Outpatient treatment of iatrogenic pneumothorax after needle biopsy. Radiology. 1997; 205: p. 249–252.
15. Laurent F, Michel P, Latrabe V, Tunon de Lara M, Marthan R. Pneumothoraces and chest tube placement after CT-guided transthoracic lung biopsy using a coaxial technique : incidence and risk factors. AJR. 1999; 172: p. 1049–1053.
16. Choi CM, Um SW, Yoo CG, et al. Incidence and Risk Factors of Delayed Pneumothorax After Transthoracic Needle Biopsy of the Lung. Chest. 2004; 126: p. 1516–1521.
17. Vatrella A, Galderisi A, Nicoletta C et al. Age as a risk factor in the occurrence of pneumothorax after transthoracic fine needle biopsy: our experience. Int J Surg. 2014; 12(Suppl 2): p. S29-S32.
18. Lim CS, Tan LE, Wang JY et al. Risk factors of pneumothorax after CT-guided coaxial cutting needle lung biopsy through aerated versus nonaerated lung. J Vasc Interv Radiol. 2014 Aug; 25(8): p 1209-12
19. Lim WH, Park CM, Yoon SH et al. Time-dependent analysis of incidence, risk factors and clinical significance of pneumothorax after percutaneous lung biopsy. Eur Radiol. 2018; 28(3): p. p1328-1337.
20. Klein JS, Salomon G, Stewart EA. Transthoracic needle biopsy with a coaxially placed 20-gauge automated cutting needle: results in 122 patients. Radiology. 1996; 198: p. 715-720.
21. Nakamura M, Yoshizako T, Koyama S, Kitagaki H. Risk factors influencing chest tube placement among patients with pneumothorax because of CT-guided needle biopsy of the lung. J Med Imaging Radiat Oncol. 2011; 55: p. 474–478.
22. Wallac MJ, Krishnamurthy S. ,Broemeling LD et al. CT-guided percutaneous fine-needle aspiration biopsy of small (< or =1-cm) pulmonary lesions. Radiology. 2002;225(3):823-828.
23. Chami HA, Faraj W, Yehia ZA et al. Predictors of pneumothorax after CT-guided transthoracic needle lung biopsy: the role of quantitative CT. Clin Radiol. 2015 Dec; 17(12): p. 1382-7.
24. Zhao Y, Wang X, Wang Y, Zhu Z. Logistic regression analysis and a risk prediction model of pneumothorax after CT-guided needle biopsy. J Thorac Dis. 2017 Nov; 9(11): p. 4750–4757.
25. Hiraki T, Mimura H, Gobara H, et al. CT fluoroscopy-guided biopsy of 1,000 pulmonary lesions performed with 20-gauge coaxial cutting needles: diagnostic yield and risk factors for diagnostic failure. Chest. 2009; 136: p. 1612 –1617.
2. Wu CC, Maher MM, Shepard JO. Complications of CT-Guided Percutaneous Needle Biopsy of the Chest: Prevention and Management. AJR. 2011; 196: p. W678–W682
3. Fish GD , Stanley JH , Miller KS , Schabel SI , Sutherland SE. Postbiopsy Pneumothorax:Estimating the Risk by Chest Radiography and Pulmonary Function Tests. AJR. 1988; 150: p. 71–74.
4. Covey AM, Gandhi R , Brody LA, Getrajdman G, Thaler HT, Brown KT. Factors associated with pneumothorax and pneumothorax requiring treatment after percutaneous lung biopsy in 443 consecutive patients. J Vasc Interv Radiol. 2004; 15: p. 479–483.
5. Khan MF, Straub R, Moghaddam SR et al. Variables affecting the risk of pneumothorax and intrapulmonary hemorrhage in CT-guided transthoracic biopsy. Eur Radiol. 2008; 18: p. 1356–1363.
6. Haaga JR, Haaga TL , Wu H. Image Guided Interventions:CT emphasis. In Haaga J, Dogra V, Forsting M, Gilkeson R, Ha H, Sundaram M, editors. CT And MRI of the Whole Body. 5th ed. Philadelphia.USA.: Mosby.Elsevier.; 2009. p. 2462-2486.
7. Yamagami T, Nakamura T, Iida S , Kato T and Nishimura T. Management of Pneumothorax After Percutaneous CT-Guided Lung Biopsy. Chest. 2002; 121: p. 1159–1164
8.Yamagami T, Kato T, Iida S, Hirota T, Yoshimatsu R, Nishimura T. Efficacy of manual aspiration immediately after complicated pneumothorax in CT-guided lung biopsy. J Vasc Interv Radiol. 2005
9. YamagamiT,Terayama K, Yoshimatsu R , Matsumoto T ,Miura H , Nishimura T. Role of Manual Aspiration in Treating Pneumothorax after Computed Tomography-Guided Lung Biopsy. Acta Radiologica. 2009
10. Kakizawa H, Toyota N, Hieda M et al. Risk factors for severity of pneumothorax after CT-guided percutaneous lung biopsy using the single-needle method. Hiroshima J Med Sci. 2010 Sep; 59(3): p. 43-50.
11. Rizzo S, Preda L, Raimondi S et al. Risk factors for complications of CT-guided lung biopsies. Radiol Med. 2011 Jun; 116(4): p. 548-63.
12. Asai N, Kawamura Y, Yamazaki I et al. Is emphysema a risk factor for pneumothorax in CT-guided lung biopsy? Springerplus. 2013; 2: p. 196.
13. Zhang HF, Liao MY, Zhu DY, Chen J, Wang YF. Lung radiodensity along the needle passage is a quantitative predictor of pneumothorax after CT-guided percutaneous core needle biopsy. Clin Radiol. 2018 Mar; 73(3): p. 319.e1-319.e7.
14. Brown KT, Brody LA, Getrajdman GI ,Napp TE. Outpatient treatment of iatrogenic pneumothorax after needle biopsy. Radiology. 1997; 205: p. 249–252.
15. Laurent F, Michel P, Latrabe V, Tunon de Lara M, Marthan R. Pneumothoraces and chest tube placement after CT-guided transthoracic lung biopsy using a coaxial technique : incidence and risk factors. AJR. 1999; 172: p. 1049–1053.
16. Choi CM, Um SW, Yoo CG, et al. Incidence and Risk Factors of Delayed Pneumothorax After Transthoracic Needle Biopsy of the Lung. Chest. 2004; 126: p. 1516–1521.
17. Vatrella A, Galderisi A, Nicoletta C et al. Age as a risk factor in the occurrence of pneumothorax after transthoracic fine needle biopsy: our experience. Int J Surg. 2014; 12(Suppl 2): p. S29-S32.
18. Lim CS, Tan LE, Wang JY et al. Risk factors of pneumothorax after CT-guided coaxial cutting needle lung biopsy through aerated versus nonaerated lung. J Vasc Interv Radiol. 2014 Aug; 25(8): p 1209-12
19. Lim WH, Park CM, Yoon SH et al. Time-dependent analysis of incidence, risk factors and clinical significance of pneumothorax after percutaneous lung biopsy. Eur Radiol. 2018; 28(3): p. p1328-1337.
20. Klein JS, Salomon G, Stewart EA. Transthoracic needle biopsy with a coaxially placed 20-gauge automated cutting needle: results in 122 patients. Radiology. 1996; 198: p. 715-720.
21. Nakamura M, Yoshizako T, Koyama S, Kitagaki H. Risk factors influencing chest tube placement among patients with pneumothorax because of CT-guided needle biopsy of the lung. J Med Imaging Radiat Oncol. 2011; 55: p. 474–478.
22. Wallac MJ, Krishnamurthy S. ,Broemeling LD et al. CT-guided percutaneous fine-needle aspiration biopsy of small (< or =1-cm) pulmonary lesions. Radiology. 2002;225(3):823-828.
23. Chami HA, Faraj W, Yehia ZA et al. Predictors of pneumothorax after CT-guided transthoracic needle lung biopsy: the role of quantitative CT. Clin Radiol. 2015 Dec; 17(12): p. 1382-7.
24. Zhao Y, Wang X, Wang Y, Zhu Z. Logistic regression analysis and a risk prediction model of pneumothorax after CT-guided needle biopsy. J Thorac Dis. 2017 Nov; 9(11): p. 4750–4757.
25. Hiraki T, Mimura H, Gobara H, et al. CT fluoroscopy-guided biopsy of 1,000 pulmonary lesions performed with 20-gauge coaxial cutting needles: diagnostic yield and risk factors for diagnostic failure. Chest. 2009; 136: p. 1612 –1617.
| Files | ||
| Issue | Vol 14 No 1 (2022) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/bccr.v14i1.14387 | |
| Keywords | ||
| CT Lung Biopsy Pneumothorax Risk factors | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Shera F, Shera T, Shah O, Robbani I, Choh N, Gojwari T, Dar A, Shah S. Computed Tomography Guided Transthoracic Lung Biopsy: Evaluating Risk Factors of Post-Procedure Pneumothorax- A Multivariate Analysis. Basic Clin Cancer Res. 2023;14(1):44-51.
