Abstract
The purpose is to evaluate the prognostic significance of lung parenchymal density during percutaneous coaxial cutting needle lung biopsy (PNLB). Retrospective analysis of 179 consecutive patients (106 males, 73 females; mean age 59.16 ± 16.34 years) undergoing PNLB was included. Mean lobar parenchymal lung density, mean densities anterior to the lesion and posterior to the chest wall in the needle trajectory path were measured in HU. Lesion location and needle trajectory were also measured. Fisher's exact test and Chi-square test were conducted to analyze the categorical variables. ANOVA test was done to examine continuous and normally distributed variables. Statistical significance was considered when p < 0.05. Mean lobar parenchymal lung density (p < 0.05) and mean parenchymal lung density relative to the needle trajectory path were below -800 HU in patients who sustained a pneumothorax. Increase in the number of pleural passes was significantly associated with the risk of patients having pneumothorax (p < 0.05). The mean distance from the skin to the lesion and needle trajectory angle were not statistically different among patients with and without pneumothorax (p > 0.05). Lobar parenchymal density and lung parenchymal density anterior to the lesion and posterior to the chest wall in the needle trajectory path could be used as predicting parameters in patients undergoing PNLB who sustained a pneumothorax. These findings can help interventional radiologist further assess risk of pneumothorax when preforming such procedure.
Highlights
The purpose is to evaluate the prognostic significance of lung parenchymal density during percutaneous coaxial cutting needle lung biopsy (PNLB)
This study aims to evaluate the possibility that lobar lung parenchymal density and lung parenchymal density relative to the trajectory path are linked to an increased risk of pneumothorax during PNLB
Lung parenchymal attenuation that was in the trajectory path of the needle (Figure 1) was determined by placing the routinely used region of interest (ROI) within the lung segments of greatest dimension in the transaxial plane and was calculated by using the average measurement over three ROI
Summary
The purpose is to evaluate the prognostic significance of lung parenchymal density during percutaneous coaxial cutting needle lung biopsy (PNLB). Conclusion: Lobar parenchymal density and lung parenchymal density anterior to the lesion and posterior to the chest wall in the needle trajectory path could be used as predicting parameters in patients undergoing PNLB who sustained a pneumothorax. These findings can help interventional radiologist further assess risk of pneumothorax when preforming such procedure. In order to facilitate repeat sampling and decrease procedural duration, the coaxial technique for percutaneous lung lesion biopsy can be used This method achieves all the aforementioned objectives without increasing the number of passes through the pleura [1]. The success rates in many quality improvement task forces are reliant on a combination of factors such as interventionist skill set, years of experience and rate of complications post PNLB
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