Abstract
ObjectivesTo determine the risk factors and complications of transthoracic computed tomography (CT)-guided core needle lung biopsy.MethodsThis is a retrospective study of 124 patients who underwent CT-guided core lung biopsy in King Khalid University Hospital (KKUH), Riyadh. This retrospective study was conducted between January 2016 and January 2020. Patient data were collected using a standardized data form that was entered into an Excel sheet in accordance with the variables. The Statistical Package for the Social Sciences software (SPSS, version 24.0 [SPSS Inc., Chicago, IL, USA]) was used to compute for the risk of complications after CT-guided core lung biopsy and perform all statistical comparisons, and the results were reported.ResultsThe overall complication rate due to CT-guided core needle biopsy was 34.7% (43) (P<0.001) of the total sample. Of the total complications, 69.76% (n = 30) had pneumothorax, 20.94% (n = 9) had hemorrhage, 6.98% (n = 3) had both pneumothorax and hemorrhage, and 2.32% (n = 1) had both air embolism and pneumothorax. Of all patients who developed pneumothorax, 20% (n = 6) required chest tube insertion. Patients with secondary chronic obstructive pulmonary disease (COPD) had a complication rate of 80% among the whole sample. Lung lesions less than 3 cm had a complication rate of 48.8% (P<0.034). The needle size showed a higher rate of complications between 20 and 18 gauge with 47.4% (n = 9) and 32.4% (n = 34), respectively.ConclusionsWe conclude that CT-guided lung biopsy is a well-established low-risk procedure that is less invasive. However, it still carries a risk of complications with some risk factors, such as small lung lesion size and secondary COPD.
Highlights
In modern medicine, computed tomography (CT) of the lung is commonly used to screen for primary lung cancer or metastatic cancer, leading to the discovery of more patients with lung masses [1,2,3]
Lung lesions less than 3 cm had a complication rate of 48.8% (P
We conclude that CT-guided lung biopsy is a well-established low-risk procedure that is less invasive
Summary
In modern medicine, computed tomography (CT) of the lung is commonly used to screen for primary lung cancer or metastatic cancer, leading to the discovery of more patients with lung masses [1,2,3]. A minimally invasive procedure such as core needle biopsy reduces the need for open surgical lung biopsy. Such procedures help confirm the diagnosis of suspected lung lesions in addition to several screening programs, one of which is the screening of high-risk groups for lung cancer. It has become widely popular across various institutions and is in constant demand for the diagnosis of different lung diseases [4,5]. Many previous studies have reported on the complications and risks of this procedure, but few have shown the correlation of these factors with the diagnostic yield of different needle gauge sizes used [1,2,7]
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