Korean J Radiol.  2020 Apr;21(5):526-536. 10.3348/kjr.2019.0492.

Usefulness of CT-Guided Percutaneous TransthoracicNeedle Lung Biopsies in Patients with SuspectedPulmonary Infection

• Kim J
• Lee KH
• Cho JY
• Kim J
• Shin YJ
• Lee KW

• KMID: 2500033
• DOI: http://doi.org/10.3348/kjr.2019.0492

Abstract

Objective
This study aimed to evaluate the clinical benefits and risks of CT-guided percutaneous transthoracic needle lung biopsies (PTNBs) in patients with a suspected pulmonary infection.
Materials and Methods
This study included 351 CT-guided PTNBs performed in 342 patients (mean age, 58.9 years [range,17–91 years]) with suspected pulmonary infection from January 2010 to December 2016. The proportion of biopsies that revealed the causative organism for pulmonary infection and that influenced patient’s treatment were measured. Multivariate analyses were performed to identify factors associated with PTNB that revealed the causative organism or affected the treatment. Finally, the complication rate was measured.
Results
CT-guided PTNB revealed the causative organism in 32.5% of biopsies (114/351). The presence of necrotic components in the lesion (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1–2.7; p = 0.028), suspected pulmonary tuberculosis (OR, 2.0; 95% CI, 1.2–3.5; p = 0.010), and fine needle aspiration (OR, 2.5; 95% CI, 1.1–5.8; p = 0.037) were factors associated with biopsies that revealed the causative organism. PTNB influenced patient’s treatment in 40.7% (143/351) of biopsies. The absence of leukocytosis (OR, 1.9; 95% CI, 1.0–3.7; p = 0.049), presence of a necrotic component in the lesion (OR, 2.4; 95% CI, 1.5–3.8; p < 0.001), and suspected tuberculosis (OR, 1.7; 95% CI, 1.0–2.8; p = 0.040) were factors associated with biopsies that influenced the treatment. The overall complication rate of PTNB was 19% (65/351).
Conclusion
In patients with suspected pulmonary infection, approximately 30–40% of CT-guided PTNBs revealed the causative organism or affected the treatment. The complication rate of PTNB for suspected pulmonary infection was relatively low.

Keyword

Image-guided biopsy; Infection; Lung; Multidetector computed tomography