Incidence of and risk factors for pneumothorax and chest tube placement after CT fluoroscopy-guided percutaneous lung biopsy

Retrospective analysis of the procedures conducted over a 9-year period

Takao Hiraki, Hidefumi Mimura, Hideo Gobara, Kentaro Shibamoto, Daisaku Inoue, Yusuke Matsui, Susumu Kanazawa

Research output: Contribution to journalArticle

95 Citations (Scopus)

Abstract

OBJECTIVE. The objective of our study was to retrospectively evaluate the incidence of and the risk factors for pneumothorax and chest tube placement after CT fluoroscopy-guided lung biopsy. MATERIALS AND METHODS. We analyzed 1,098 CT fluoroscopy-guided lung biopsies conducted with 20-gauge coaxial cutting needles for 1,155 lesions in 1,033 patients. Apart from evaluating the incidence of pneumothorax and chest tube placement, the independent risk factors for pneumothorax and chest tube placement for pneumothorax were determined using multivariate logistic regression analysis. RESULTS. The overall incidence of pneumothorax was 42.3% (464/1,098). Chest tube placement was required for 11.9% (55/464) of pneumothoraces (5.0% [55/1,098] of the total number of procedures). The significant independent risk factors for pneumothorax were no prior pulmonary surgery (p = 0.001), lesions in the lower lobe (p <0.001), greater lesion depth (p <0.001), and a needle trajectory angle of <45° (p = 0.014); those for chest tube placement for pneumothorax were pulmonary emphysema (p <0.001) and greater lesion depth (p <0.001). CONCLUSION. Pneumothorax frequently occurred and placement of a chest tube was occasionally required for pneumothorax after CT fluoroscopy-guided lung biopsy. To reduce the risk of pneumothorax necessitating chest tube placement, physicians should adopt the shortest needle path to the lesion.

Original languageEnglish
Pages (from-to)809-814
Number of pages6
JournalAmerican Journal of Roentgenology
Volume194
Issue number3
DOIs
Publication statusPublished - Mar 2010

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Chest Tubes
Fluoroscopy
Pneumothorax
Biopsy
Lung
Incidence
Needles
Pulmonary Emphysema
Logistic Models
Regression Analysis

Keywords

  • Chest tube placement
  • Complications
  • CT
  • Lung biopsy
  • Pneumothorax
  • Pulmonary neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

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title = "Incidence of and risk factors for pneumothorax and chest tube placement after CT fluoroscopy-guided percutaneous lung biopsy: Retrospective analysis of the procedures conducted over a 9-year period",
abstract = "OBJECTIVE. The objective of our study was to retrospectively evaluate the incidence of and the risk factors for pneumothorax and chest tube placement after CT fluoroscopy-guided lung biopsy. MATERIALS AND METHODS. We analyzed 1,098 CT fluoroscopy-guided lung biopsies conducted with 20-gauge coaxial cutting needles for 1,155 lesions in 1,033 patients. Apart from evaluating the incidence of pneumothorax and chest tube placement, the independent risk factors for pneumothorax and chest tube placement for pneumothorax were determined using multivariate logistic regression analysis. RESULTS. The overall incidence of pneumothorax was 42.3{\%} (464/1,098). Chest tube placement was required for 11.9{\%} (55/464) of pneumothoraces (5.0{\%} [55/1,098] of the total number of procedures). The significant independent risk factors for pneumothorax were no prior pulmonary surgery (p = 0.001), lesions in the lower lobe (p <0.001), greater lesion depth (p <0.001), and a needle trajectory angle of <45° (p = 0.014); those for chest tube placement for pneumothorax were pulmonary emphysema (p <0.001) and greater lesion depth (p <0.001). CONCLUSION. Pneumothorax frequently occurred and placement of a chest tube was occasionally required for pneumothorax after CT fluoroscopy-guided lung biopsy. To reduce the risk of pneumothorax necessitating chest tube placement, physicians should adopt the shortest needle path to the lesion.",
keywords = "Chest tube placement, Complications, CT, Lung biopsy, Pneumothorax, Pulmonary neoplasms",
author = "Takao Hiraki and Hidefumi Mimura and Hideo Gobara and Kentaro Shibamoto and Daisaku Inoue and Yusuke Matsui and Susumu Kanazawa",
year = "2010",
month = "3",
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T1 - Incidence of and risk factors for pneumothorax and chest tube placement after CT fluoroscopy-guided percutaneous lung biopsy

T2 - Retrospective analysis of the procedures conducted over a 9-year period

AU - Hiraki, Takao

AU - Mimura, Hidefumi

AU - Gobara, Hideo

AU - Shibamoto, Kentaro

AU - Inoue, Daisaku

AU - Matsui, Yusuke

AU - Kanazawa, Susumu

PY - 2010/3

Y1 - 2010/3

N2 - OBJECTIVE. The objective of our study was to retrospectively evaluate the incidence of and the risk factors for pneumothorax and chest tube placement after CT fluoroscopy-guided lung biopsy. MATERIALS AND METHODS. We analyzed 1,098 CT fluoroscopy-guided lung biopsies conducted with 20-gauge coaxial cutting needles for 1,155 lesions in 1,033 patients. Apart from evaluating the incidence of pneumothorax and chest tube placement, the independent risk factors for pneumothorax and chest tube placement for pneumothorax were determined using multivariate logistic regression analysis. RESULTS. The overall incidence of pneumothorax was 42.3% (464/1,098). Chest tube placement was required for 11.9% (55/464) of pneumothoraces (5.0% [55/1,098] of the total number of procedures). The significant independent risk factors for pneumothorax were no prior pulmonary surgery (p = 0.001), lesions in the lower lobe (p <0.001), greater lesion depth (p <0.001), and a needle trajectory angle of <45° (p = 0.014); those for chest tube placement for pneumothorax were pulmonary emphysema (p <0.001) and greater lesion depth (p <0.001). CONCLUSION. Pneumothorax frequently occurred and placement of a chest tube was occasionally required for pneumothorax after CT fluoroscopy-guided lung biopsy. To reduce the risk of pneumothorax necessitating chest tube placement, physicians should adopt the shortest needle path to the lesion.

AB - OBJECTIVE. The objective of our study was to retrospectively evaluate the incidence of and the risk factors for pneumothorax and chest tube placement after CT fluoroscopy-guided lung biopsy. MATERIALS AND METHODS. We analyzed 1,098 CT fluoroscopy-guided lung biopsies conducted with 20-gauge coaxial cutting needles for 1,155 lesions in 1,033 patients. Apart from evaluating the incidence of pneumothorax and chest tube placement, the independent risk factors for pneumothorax and chest tube placement for pneumothorax were determined using multivariate logistic regression analysis. RESULTS. The overall incidence of pneumothorax was 42.3% (464/1,098). Chest tube placement was required for 11.9% (55/464) of pneumothoraces (5.0% [55/1,098] of the total number of procedures). The significant independent risk factors for pneumothorax were no prior pulmonary surgery (p = 0.001), lesions in the lower lobe (p <0.001), greater lesion depth (p <0.001), and a needle trajectory angle of <45° (p = 0.014); those for chest tube placement for pneumothorax were pulmonary emphysema (p <0.001) and greater lesion depth (p <0.001). CONCLUSION. Pneumothorax frequently occurred and placement of a chest tube was occasionally required for pneumothorax after CT fluoroscopy-guided lung biopsy. To reduce the risk of pneumothorax necessitating chest tube placement, physicians should adopt the shortest needle path to the lesion.

KW - Chest tube placement

KW - Complications

KW - CT

KW - Lung biopsy

KW - Pneumothorax

KW - Pulmonary neoplasms

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DO - 10.2214/AJR.09.3224

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JF - American Journal of Roentgenology

SN - 0361-803X

IS - 3

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