Imaging surveillance for pneumothorax after CT-guided lung biopsy: Conclusions from a year of data at a tertiary care center

Abstract

This study was performed to identify the minimum observational time and post-procedural imaging necessary before safely discharging a patient after CT-guided lung biopsy. Retrospective chart review was conducted on 167 CT-guided lung biopsies performed in 2015 at our institution to determine how often pneumothoraces occurred, and when they were first noted on post-procedure chest imaging. Patient age, gender, lesion laterality and size, core needle size, and background emphysema on imaging, as well as clinical history of chronic obstructive pulmonary disease were recorded. If pneumothorax occurred, its size, need for chest tube, and ultimate medical outcomes were logged. Chi squared statistical analysis was utilized. Post-biopsy R7% incldi al the time of the biopsy and 13% within the first hour. No new pneumothorax was deleted beyond the first hour Overall pneumothorax intervention rate was The leading risk factor for pneumothorax wat concomitant radiographic evidence of emphysema, with 48% incidence versus 30% of patients without underlying emphysema. These patients were also significantly more likely to have a pneumothorax requiring intervention (p<0.05). We concluded that post-biopsy imaging can safely be limited to immediate post-procedure CT and one hour chest radiograph in the absence of pneumothorax. In patients with pneumothorax, further imaging, intervention, and/or discharge may be considered based on imaging results and patient's condition.