TY - JOUR
T1 - The effect of intraparenchymal blood patching on the rate of pneumothorax in patients undergoing percutaneous CT-guided core biopsy of the lung
AU - Perl, R. M.
AU - Risse, E.
AU - Hetzel, J.
AU - Bösmüller, H.
AU - Kloth, C.
AU - Fritz, J.
AU - Horger, M.
N1 - Funding Information:
Jan Fritz received institutional research funds and speaker's honorarium from Siemens Healthcare USA and is a scientific advisor of Siemens Healthcare USA and Alexion Pharamceuticals, Inc.Marius Horger received institutional research funds and speaker's honorarium from Siemens Healthineers and is a scientific advisor of Siemens Healthcare Germany. The other authors have declared that no competing interests exist.
Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/7
Y1 - 2019/7
N2 - Purpose: To assess the effect of intraparenchymal blood patching (IBP)as well as tumor- and operator-related risk factors on the rate of pneumothoraxes after percutaneous CT-guided core needle biopsy of the lung. Materials and methods: We performed a retrospective analysis of 868 CT-guided lung biopsies that were conducted at our institution between 2003 and 2018, of which 419 (48%)received an IBP. Outcome variable included the rates of pneumothorax and chest tube placement, as well as lesion size (<3 cm versus ≥3 cm long axis diameter), lesion depth (≤2 cm, >2-4 cm, >4-5 cm and >5 cm distance to the pleura), location within the lungs (upper lobe, lower lobe, middle lobe), needle caliber (13 G, 15 G, 17 G, 19 G), number of samples taken (1–3 versus ≥4 samples), and experience of the performing physician. Results: The rate of pneumothorax was significantly (p < 0.05)lower in the group with IBP (10.7%)compared to the group without IBP (15.4%). The number of post-interventional chest tube placements was also lower in the IBP group (3.1% vs. 5.8%)but not statistically significant. The lesion size correlated negatively with the rate of pneumothoraxes, whereas in both groups (±IBP)lesions ≥ 3 cm showed a significantly lower rate of pneumothorax (p < 0.05). With increasing lesion depth, the pneumothorax rate increased with (p < 0.01)and without (p < 0.001)IBP. The rate of pneumothorax was significantly lower (p < 0.05)for 17 G needles with IBP, but not for other calibers. For biopsies in the lower lobe, the pneumothorax rate reduced significantly (p < 0.001)with IBP. In case of ≥4 tissue samples, the pneumothorax rate was significantly lower with IBP (p < 0.01). For experienced operators, the overall pneumothorax rate was significantly lower compared to less experienced operators (p < 0001). Conclusions: IBP significantly reduces the rate of pneumothorax following CT-guided lung biopsies in particular for lesions located deeper in the lungs, when ≥4 samples are taken, when samples are taken by less-experienced operators, and when sampling from the lower lobes.
AB - Purpose: To assess the effect of intraparenchymal blood patching (IBP)as well as tumor- and operator-related risk factors on the rate of pneumothoraxes after percutaneous CT-guided core needle biopsy of the lung. Materials and methods: We performed a retrospective analysis of 868 CT-guided lung biopsies that were conducted at our institution between 2003 and 2018, of which 419 (48%)received an IBP. Outcome variable included the rates of pneumothorax and chest tube placement, as well as lesion size (<3 cm versus ≥3 cm long axis diameter), lesion depth (≤2 cm, >2-4 cm, >4-5 cm and >5 cm distance to the pleura), location within the lungs (upper lobe, lower lobe, middle lobe), needle caliber (13 G, 15 G, 17 G, 19 G), number of samples taken (1–3 versus ≥4 samples), and experience of the performing physician. Results: The rate of pneumothorax was significantly (p < 0.05)lower in the group with IBP (10.7%)compared to the group without IBP (15.4%). The number of post-interventional chest tube placements was also lower in the IBP group (3.1% vs. 5.8%)but not statistically significant. The lesion size correlated negatively with the rate of pneumothoraxes, whereas in both groups (±IBP)lesions ≥ 3 cm showed a significantly lower rate of pneumothorax (p < 0.05). With increasing lesion depth, the pneumothorax rate increased with (p < 0.01)and without (p < 0.001)IBP. The rate of pneumothorax was significantly lower (p < 0.05)for 17 G needles with IBP, but not for other calibers. For biopsies in the lower lobe, the pneumothorax rate reduced significantly (p < 0.001)with IBP. In case of ≥4 tissue samples, the pneumothorax rate was significantly lower with IBP (p < 0.01). For experienced operators, the overall pneumothorax rate was significantly lower compared to less experienced operators (p < 0001). Conclusions: IBP significantly reduces the rate of pneumothorax following CT-guided lung biopsies in particular for lesions located deeper in the lungs, when ≥4 samples are taken, when samples are taken by less-experienced operators, and when sampling from the lower lobes.
KW - Blood patching
KW - Lung biopsy
KW - Pneumothorax
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U2 - 10.1016/j.ejrad.2019.04.010
DO - 10.1016/j.ejrad.2019.04.010
M3 - Article
C2 - 31153555
AN - SCOPUS:85064701571
SN - 0720-048X
VL - 116
SP - 14
EP - 20
JO - European Journal of Radiology
JF - European Journal of Radiology
ER -