PERCUTANEOUS CT-GUIDED CORE BIOPSY OF THE LUNG: IS THERE ANY BENEFIT FROM USING INTRAPARENCHYMAL BLOOD PATCHING?

Abstract

SESSION TITLE: Tuesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/22/2019 01:00 PM - 02:00 PM PURPOSE: To assess the effect of intraparenchymal blood patching (IBP) as well as tumor- and operator-related risk factors on the rate of pneumothoraces after percutaneous CT-guided core needle biopsy of the lung. METHODS: Following institutional review board approval, we performed a retrospective analysis of 868 CT-guided lung biopsies that were performed at our institution between 2003 and 2018, of which 419 (48%) received an IPB. Outcome variable included the rates of pneumothorax and chest tube placement, as well as lesion size (< 3 cm versus ≥ 3 cm long axis diameter), lesion depth (< 2 cm, < 4 cm, < 5 cm and > 5 cm distance to the pleura), location within the lungs, needle caliber, number of samples taken (1-3 versus ≥ 4 samples), and experience of the performing physician. RESULTS: The rate of pneumothorax was significantly (p < 0.05) lower in the group with IPB (10.7%) compared to the group without IPB (15.4%). The number of post-interventional chest tube placements differed also between the groups with IPB (3.1%) vs. non-IPB (5.8%). The lesion size correlated negatively with the rate of pneumothoraces, whereas in both groups (±IBP) lesions > 3 cm showed a significantly lower rate of pneumothorax (p < 0.05). With increasing lesion depth the pneumothorax rate increased with (p < 0.001) and without (p < 0.001) IPB. The rate of pneumothorax was significantly lower (p < 0.05) for 17G needles with IPB, but not for other calibers. For biopsies in the lower lobe, the pneumothorax rate reduced significantly (p < 0.001) with IPB. The rate of pneumothorax differed from 11.1% with IPB to 24.8% without IPB only for less experienced operators. In case of > 3 tissue samples, the pneumothorax rate was significantly lower with IPB (p < 0.01). CONCLUSIONS: IPB significantly reduces the rate of pneumothorax following CT-guided lung biopsies in particular for lesions located deeper in the lungs, when more than 3 samples are taken, when samples are taken by less-experienced operators, and when sampling from the lower lobes. CLINICAL IMPLICATIONS: IPB reduces the risk of pneumthoracs of CT-guided percutanous biopsies. DISCLOSURES: Workshop and Pesentation relationship with Erbe, Medizintechnik GmbH, Tuebingen, Germany Please note: $1-$1000 Added 01/07/2019 by Juergen Hetzel, source=Web Response, value=Honoraria No relevant relationships by Marius Horger, source=Web Response No relevant relationships by Regine Mariette Perl, source=Web Response no disclosure on file for Werner Spengler