RT Journal Article
SR Electronic
T1 Clinical and radiological predictors of post-procedure pneumothorax complicating CT-guided lung biopsy
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P424
VO 42
IS Suppl 57
A1 Robert Scott
A1 Matthew Patterson
A1 Stephen Cooper
A1 Michael Dean
A1 Anur Guhan
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P424.abstract
AB INTRODUCTION: CT-guided lung biopsy (CTLB) is a common diagnostic test in the work-up of peripheral lung lesions. Post CTLB Pneumothoraces (PT) are a recognised complication. The BTS CTLB guidelines recommend this should be < 20.5%, with 3.1% requiring intercostal chest drainage (ICD). Pre-CTLB spirometry is recommended. Pre-CTLB DLCO measurement is not explicitly recommended.OBJECTIVES: To ascertain by a retrospective audit of our CTLB practice in two Ayrshire Hospitals, our post-CTLB PT rate and its management and identify clinical or radiological factors that could have predicted the complication.METHODS: Case notes and radiological images of 131 patients who had CTLB in 2012 were perused for patient demographics, radiological size of the lesion, its depth from the pleura, presence of emphysema around the lesion, DLCO measurements (whether performed before or after CTLB) and post-CTLB PT and its management.RESULTS: Among 131 CTLB patients, there were 39 (30%) PT. 6(4.6%) required ICD. Only 30% had PFTs before CTLB. PT rates were higher with smaller and deeper lesions, emphysema around the lesion, and with reduced DLCO values.CONCLUSIONS: Our post-CTLB PT rate was higher than the BTS recommendations. Given the correlation between DLCO and risk of PT, measuring DLCO prior to all CTLB could be one change of practice that could potentially help reduce or predict this complication.