Pneumothorax after computed tomography-guided lung biopsy: Utility of immediate post-procedure computed tomography and one-hour delayed chest radiography
<h4>Purpose</h4> To evaluate the utility of immediate post-procedure computed tomography (IPP-CT) and routine one-hour chest radiography (1HR-CXR) for detecting and managing pneumothorax in patients undergoing computed tomography (CT)-guided percutaneous lung biopsy. <h4>Materials...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10115279/?tool=EBI |
| _version_ | 1827962754867134464 |
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| author | Jared Thomas Weinand Lourens du Pisanie Smith Ngeve Clayton Commander Hyeon Yu |
| author_facet | Jared Thomas Weinand Lourens du Pisanie Smith Ngeve Clayton Commander Hyeon Yu |
| author_sort | Jared Thomas Weinand |
| collection | DOAJ |
| description | <h4>Purpose</h4> To evaluate the utility of immediate post-procedure computed tomography (IPP-CT) and routine one-hour chest radiography (1HR-CXR) for detecting and managing pneumothorax in patients undergoing computed tomography (CT)-guided percutaneous lung biopsy. <h4>Materials and methods</h4> All CT-guided percutaneous lung biopsies performed between May 2014 and August 2021 at a single institution were included. Data from 275 procedures performed on 267 patients (147 men; mean age: 63.5 ± 14.1 years; range 18–91 years) who underwent routine 1HR-CXR were reviewed. Incidences of pneumothorax and procedure-related complications on IPP-CT and 1HR-CXR were recorded. Associated variables, including tract embolization methods, needle diameter/type, access site, lesion size, needle tract distance, and number of biopsy samples obtained were analyzed and compared between groups with and without pneumothorax. <h4>Results</h4> Post-procedure complications included pneumothorax (30.9%, 85/275) and hemoptysis (0.7%, 2/275). Pneumothorax was detected on IPP-CT and 1HR-CXR in 89.4% (76/85) and 100% (85/85), respectively. A chest tube was placed in 4% (11/275) of the cases. In 3.3% (9/275) of the cases, delayed pneumothorax was detected only on 1HR-CXR, but no patient in this group necessitated chest tube placement. The incidence of pneumothorax was not significantly different between tract embolization methods (p = 0.36), needle diameters (p = 0.36) and types (p = 0.33), access sites (p = 0.07), and lesion sizes (p = 0.88). On logistic regression, a lower biopsy sample number (OR = 0.49) was a protective factor, but a longer needle tract distance (OR = 1.16) was a significant risk factor for pneumothorax. <h4>Conclusion</h4> Following CT-guided percutaneous lung biopsy, pneumothorax detected on IPP-CT strongly indicates persistent pneumothorax on 1HR-CXR and possible chest tube placement. If no pneumothorax is identified on IPP-CT, follow-up 1HR-CXR may be required only for those who develop symptoms of pneumothorax. |
| first_indexed | 2024-04-09T16:47:56Z |
| format | Article |
| id | doaj.art-593f189d20bb452bae9b0d96fc1c0009 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-09T16:47:56Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-593f189d20bb452bae9b0d96fc1c00092023-04-22T05:31:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01184Pneumothorax after computed tomography-guided lung biopsy: Utility of immediate post-procedure computed tomography and one-hour delayed chest radiographyJared Thomas WeinandLourens du PisanieSmith NgeveClayton CommanderHyeon Yu<h4>Purpose</h4> To evaluate the utility of immediate post-procedure computed tomography (IPP-CT) and routine one-hour chest radiography (1HR-CXR) for detecting and managing pneumothorax in patients undergoing computed tomography (CT)-guided percutaneous lung biopsy. <h4>Materials and methods</h4> All CT-guided percutaneous lung biopsies performed between May 2014 and August 2021 at a single institution were included. Data from 275 procedures performed on 267 patients (147 men; mean age: 63.5 ± 14.1 years; range 18–91 years) who underwent routine 1HR-CXR were reviewed. Incidences of pneumothorax and procedure-related complications on IPP-CT and 1HR-CXR were recorded. Associated variables, including tract embolization methods, needle diameter/type, access site, lesion size, needle tract distance, and number of biopsy samples obtained were analyzed and compared between groups with and without pneumothorax. <h4>Results</h4> Post-procedure complications included pneumothorax (30.9%, 85/275) and hemoptysis (0.7%, 2/275). Pneumothorax was detected on IPP-CT and 1HR-CXR in 89.4% (76/85) and 100% (85/85), respectively. A chest tube was placed in 4% (11/275) of the cases. In 3.3% (9/275) of the cases, delayed pneumothorax was detected only on 1HR-CXR, but no patient in this group necessitated chest tube placement. The incidence of pneumothorax was not significantly different between tract embolization methods (p = 0.36), needle diameters (p = 0.36) and types (p = 0.33), access sites (p = 0.07), and lesion sizes (p = 0.88). On logistic regression, a lower biopsy sample number (OR = 0.49) was a protective factor, but a longer needle tract distance (OR = 1.16) was a significant risk factor for pneumothorax. <h4>Conclusion</h4> Following CT-guided percutaneous lung biopsy, pneumothorax detected on IPP-CT strongly indicates persistent pneumothorax on 1HR-CXR and possible chest tube placement. If no pneumothorax is identified on IPP-CT, follow-up 1HR-CXR may be required only for those who develop symptoms of pneumothorax.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10115279/?tool=EBI |
| spellingShingle | Jared Thomas Weinand Lourens du Pisanie Smith Ngeve Clayton Commander Hyeon Yu Pneumothorax after computed tomography-guided lung biopsy: Utility of immediate post-procedure computed tomography and one-hour delayed chest radiography PLoS ONE |
| title | Pneumothorax after computed tomography-guided lung biopsy: Utility of immediate post-procedure computed tomography and one-hour delayed chest radiography |
| title_full | Pneumothorax after computed tomography-guided lung biopsy: Utility of immediate post-procedure computed tomography and one-hour delayed chest radiography |
| title_fullStr | Pneumothorax after computed tomography-guided lung biopsy: Utility of immediate post-procedure computed tomography and one-hour delayed chest radiography |
| title_full_unstemmed | Pneumothorax after computed tomography-guided lung biopsy: Utility of immediate post-procedure computed tomography and one-hour delayed chest radiography |
| title_short | Pneumothorax after computed tomography-guided lung biopsy: Utility of immediate post-procedure computed tomography and one-hour delayed chest radiography |
| title_sort | pneumothorax after computed tomography guided lung biopsy utility of immediate post procedure computed tomography and one hour delayed chest radiography |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10115279/?tool=EBI |
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