Computed tomography‑guided lung biopsy: Association between biopsy needle angle and pneumothorax development

Kuriyama,Takumi; Masago,Katsuhiro; Okada,Yuki; Katakami,Nobuyuki

doi:10.3892/mco.2017.1512

Computed tomography‑guided lung biopsy: Association between biopsy needle angle and pneumothorax development

Authors:
- Takumi Kuriyama
- Katsuhiro Masago
- Yuki Okada
- Nobuyuki Katakami
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Affiliations: Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya 461-8673, Japan, Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya 464-8681, Japan, Radiological Technology, Institute of Biomedical Research and Innovation, Kobe 650-0047, Japan, Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe 650-0047, Japan
Published online on: November 27, 2017 https://doi.org/10.3892/mco.2017.1512
Pages: 336-341

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Abstract

Computed tomography (CT)‑guided lung biopsy is a well‑established diagnostic method for pulmonary lesions. However, the use of this technique often results in pneumothorax development. The aim of the present study was to evaluate the association between biopsy needle angle and pneumothorax development associated with computed tomography‑guided lung biopsy. We retrospectively analyzed the results of CT‑guided lung biopsies for 325 cases to investigate physical risk factors for pneumothorax development. Biopsy needle angle and patient positioning were included in the analysis. Pneumothorax occurred in 160 of 325 procedures (49.2%). Discontinuation of the procedure as a result of pneumothorax occurred in 18 of 160 procedures (11.2%). Upper lung lobe pneumothorax occurred in 40.8% (58/142), middle lobe in 17.6% (25/142), and lower lobe pneumothorax occurred in 41.5% (59/142) of these procedures. Discontinuation of the procedure occurred in 2.5% of the upper lobe (4/160), 0.6% of the middle lobe (1/160), and 8.1% of the lower lobe (13/160) biopsies. Mild pneumothorax occurred in 59.4% (95/160), moderate in 25.0% (40/160), and severe in 7.5% (12/160) of the affected cases, and biopsy was discontinued in 11.2% (18/160) of the affected cases. When the needle angle was <90˚, 40.3% (131/325) of the patients experienced no pneumothorax development, 40.0% (130/325) developed pneumothorax, and 4.3% (14/325) of the procedures were discontinued. The results showed that use of CT‑guided lung biopsy can reduce the rate of pneumothorax development that occurs when other procedures are used. The access route is simple and easy to puncture, and proper use of breath holding reduces diaphragmatic movement.

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