Korean J Radiol.  2019 Feb;20(2):323-331. 10.3348/kjr.2018.0064.

Analysis of Complications of Percutaneous Transthoracic Needle Biopsy Using CT-Guidance Modalities In a Multicenter Cohort of 10568 Biopsies

Affiliations
  • 1Department of Radiology, Seoul National University College of Medicine, Seoul, Korea. cmpark.morphius@gmail.com
  • 2Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.
  • 3Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 4Department of Radiology, National Cancer Center, Goyang, Korea.
  • 5Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 6Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 7Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 8Department of Radiology, Inje University Sanggye Paik Hospital, Seoul, Korea.
  • 9Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
  • 10Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea.
  • 11Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea.

Abstract


OBJECTIVE
To analyze the complications of percutaneous transthoracic needle biopsy using CT-based imaging modalities for needle guidance in comparison with fluoroscopy in a large retrospective cohort.
MATERIALS AND METHODS
This study was approved by multiple Institutional Review Boards and the requirement for informed consent was waived. We retrospectively included 10568 biopsies from eight referral hospitals from 2010 through 2014. In univariate and multivariate logistic analyses, 3 CT-based guidance modalities (CT, CT fluoroscopy, and cone-beam CT) were compared with fluoroscopy in terms of the risk of pneumothorax, pneumothorax requiring chest tube insertion, and hemoptysis, with adjustment for other risk factors.
RESULTS
Pneumothorax occurred in 2298 of the 10568 biopsies (21.7%). Tube insertion was required after 316 biopsies (3.0%), and hemoptysis occurred in 550 cases (5.2%). In the multivariate analysis, pneumothorax was more frequently detected with CT {odds ratio (OR), 2.752 (95% confidence interval [CI], 2.325-3.258), p < 0.001}, CT fluoroscopy (OR, 1.440 [95% CI, 1.176-1.762], p < 0.001), and cone-beam CT (OR, 2.906 [95% CI, 2.235-3.779], p < 0.001), but no significant relationship was found for pneumothorax requiring chest tube insertion (p = 0.497, p = 0.222, and p = 0.216, respectively). The incidence of hemoptysis was significantly lower under CT (OR, 0.348 [95% CI, 0.247-0.491], p < 0.001), CT fluoroscopy (OR, 0.594 [95% CI, 0.419-0.843], p = 0.004), and cone-beam CT (OR, 0.479 [95% CI, 0.317-0.724], p < 0.001) guidance.
CONCLUSION
Hemoptysis occurred less frequently with CT-based guidance modalities in comparison with fluoroscopy. Although pneumothorax requiring chest tube insertion showed a similar incidence, pneumothorax was more frequently detected using CT-based guidance modalities.

Keyword

Lung neoplasms; Biopsy; Image-guided biopsy; Pneumothorax; Hemoptysis; CT; CT fluoroscopy; Cone-beam CT

MeSH Terms

Biopsy*
Biopsy, Needle*
Chest Tubes
Cohort Studies*
Cone-Beam Computed Tomography
Ethics Committees, Research
Fluoroscopy
Hemoptysis
Image-Guided Biopsy
Incidence
Informed Consent
Lung Neoplasms
Multivariate Analysis
Needles*
Pneumothorax
Referral and Consultation
Retrospective Studies
Risk Factors

Figure

  • Fig. 1 Flow diagram of patient inclusion.F = female, M = male


Cited by  2 articles

Diagnostic Accuracy of Percutaneous Transthoracic Needle Lung Biopsies: A Multicenter Study
Kyung Hee Lee, Kun Young Lim, Young Joo Suh, Jin Hur, Dae Hee Han, Mi-Jin Kang, Ji Yung Choo, Cherry Kim, Jung Im Kim, Soon Ho Yoon, Woojoo Lee, Chang Min Park
Korean J Radiol. 2019;20(8):1300-1310.    doi: 10.3348/kjr.2019.0189.

Non-Diagnostic CT-Guided Percutaneous Needle Biopsy of the Lung: Predictive Factors and Final Diagnoses
Thanisa Tongbai, Shaunagh McDermott, Nantaka Kiranantawat, Victorine Vining Muse, Carol Chia-chia Wu, Jo-Anne O'Malley Shepard, Matthew David Gilman
Korean J Radiol. 2019;20(11):1515-1526.    doi: 10.3348/kjr.2019.0014.


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