Medical Journal of The Islamic Republic of Iran (MJIRI)
Iran University of Medical Sciences
Sun, Oct 12, 2025
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Volume 39, Issue 1 (1-2025)
Med J Islam Repub Iran 2025 |
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Sasani M R, Paknahad M. Complications of CT-Guided Percutaneous Lung Biopsy: A 1-Year Single-Center Experience in Iran. Med J Islam Repub Iran 2025; 39 (1) :912-921
URL: http://mjiri.iums.ac.ir/article-1-9655-en.html
URL: http://mjiri.iums.ac.ir/article-1-9655-en.html
Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran , majidpaknahad@gmail.com
Abstract: (182 Views)
Background: Despite observing all precautions, complications are not uncommon during transthoracic needle biopsy (TTNB). We aimed to evaluate the complications associated with TTNB in patients with lung masses from 1 center in southern Iran.
Methods: In this retrospective cohort study, data on complication rates, types, and potential risk factors from 87 biopsies were collected. Complications were assessed through immediate post-biopsy computed tomography (CT) scans and follow-up chest X-rays, and their correlations were evaluated with patient demographics, lesion characteristics, and procedural factors. Chi-square and Wilcoxon rank-sum tests were used for univariable analysis, and multivariable binary logistic regression analyses were conducted to control for potential confounders.
Results: The overall complication rate was 37.9% (95% CI, 27.6%-48.3%), with pneumothorax being the most common, occurring in 26.4% (95% CI, 17.3%-35.6%) of cases, followed by perilesional hemorrhage (17.2%) (95% CI, 10.3%-25.3%), hemoptysis (3.3%), and pleural effusion (1.1%). All pneumothorax cases were identified via immediate post-biopsy CT, and only 1 patient required chest tube insertion. No significant correlations were found between age, sex, presence of emphysema, lesion size, location, and depth, or needle path and the incidence of pneumothorax. However, a significantly higher perilesional hemorrhage incidence was observed for smaller lesion size (26 mm [interquartile range, IQR], 13,40 vs 43 mm [IQR, 24,73]; P = 0.019), deeper lesion (10 mm [IQR, 0.17] vs 0 mm [IQR, 0.10]; P = 0.041), and longer needle path (17 mm [IQR, 9.29] vs 0 mm [IQR, 0.7]; P < 0.001). Furthermore, 47.8% of pneumothorax cases identified on postbiopsy CT showed no signs on follow-up chest X-ray 3 hours later.
Conclusion: TTNB is generally safe, with a manageable complication profile. Early detection and appropriate follow-up are crucial, particularly for pneumothorax, which often resolves spontaneously. The findings underscore the importance of considering lesion characteristics to minimize complications during biopsy procedures.
Methods: In this retrospective cohort study, data on complication rates, types, and potential risk factors from 87 biopsies were collected. Complications were assessed through immediate post-biopsy computed tomography (CT) scans and follow-up chest X-rays, and their correlations were evaluated with patient demographics, lesion characteristics, and procedural factors. Chi-square and Wilcoxon rank-sum tests were used for univariable analysis, and multivariable binary logistic regression analyses were conducted to control for potential confounders.
Results: The overall complication rate was 37.9% (95% CI, 27.6%-48.3%), with pneumothorax being the most common, occurring in 26.4% (95% CI, 17.3%-35.6%) of cases, followed by perilesional hemorrhage (17.2%) (95% CI, 10.3%-25.3%), hemoptysis (3.3%), and pleural effusion (1.1%). All pneumothorax cases were identified via immediate post-biopsy CT, and only 1 patient required chest tube insertion. No significant correlations were found between age, sex, presence of emphysema, lesion size, location, and depth, or needle path and the incidence of pneumothorax. However, a significantly higher perilesional hemorrhage incidence was observed for smaller lesion size (26 mm [interquartile range, IQR], 13,40 vs 43 mm [IQR, 24,73]; P = 0.019), deeper lesion (10 mm [IQR, 0.17] vs 0 mm [IQR, 0.10]; P = 0.041), and longer needle path (17 mm [IQR, 9.29] vs 0 mm [IQR, 0.7]; P < 0.001). Furthermore, 47.8% of pneumothorax cases identified on postbiopsy CT showed no signs on follow-up chest X-ray 3 hours later.
Conclusion: TTNB is generally safe, with a manageable complication profile. Early detection and appropriate follow-up are crucial, particularly for pneumothorax, which often resolves spontaneously. The findings underscore the importance of considering lesion characteristics to minimize complications during biopsy procedures.
Keywords: Interventional radiology, Image-Guided Biopsy, Lung, Complications, Pneumothorax, Hemorrhage
Type of Study: Original Research |
Subject:
Radiology
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