CT GUIDED BIOPSY: 146 CASE REVIEW

ABSTRACT
Introduction: A lung biopsy is a procedure performed to assess a specimen from the lung for disease or cancer. It
is a multidisciplinary. procedure involving the pulmonologists, pathologists, and radiologists with an interest in chest
diseases. Lesion depth. is the predominant risk factor for pneumothorax in patients undergoing CT-guided transthoracic
lung biopsy. The aims of this study. were to estimate the risk of pneumothorax in patients undergoing CT-guided lung
biopsy and to determine which factors effect its occurrence.
Materials & Methods: It was a retrospective study conducted on 146 cases from June 2015 to June 2016. Data was
collected from the archives of the Liverpool Heart and Lung Hospital using a performa that included parameters such
as gender/age, Forced Expiratory Volume (FEV1), size of lesion, chest wall thickness, distance of lesion from pleura,
rate of pneumothorax, number of needle passes and grade of operator. Statistical Analysis was performed at the Cardiothoracic
Centre Liverpool NHS Trust Chest unit using Statistical Package for Social Sciences (SPSS) version 13.0.
Results: Out of the total 146 cases in this study, 45 patients (30.82%) developed Pneumothorax while 101 patients
(69.18%) did not. The most common anatomical site of lesion was the Left Upper Lobe (35.33%). Out of the patients
developing Pneumothorax, 26 patients (30.59%) developed Pneumothorax after one pass. On the contrary, 59 patients
(77.63%) did not develop Pneumothorax after one pass. A similar trend was seen in the other patients who underwent
more than one pleural pass. The mean size of lesion in patients that develop Pneumothorax after CT guided biopsy
was 3.0 cm. In the patients who did not develop Pneumothorax, mean size of lesion was 3.8 cm. The mean distance
of pleura to site of lesion in patients who developed Pneumothorax was 2.5 cm.
Conclusion: Technically difficult biopsies were done by consultants with high complication rate. The smaller and
deeper. lesions were associated with a high rate of Pneumothorax and the rate of pneumothorax was not affected by
no of passes, chest wall thickness, FEV1, gender or age (p = NS) however, the distance from pleura and size of lesion
(p<0.05) affects it.
Key-words: CT, Pneumothorax, Percutaneous Biopsy