Abstract
CT guided lung biopsy is an important diagnostic tool for lung tumours. Quoted pneumothorax rates are wide at 0-61%1. This study aims to assess our pneumothorax rate and outcomes by reviewing radiology, spirometry and biopsy methods for CT guided lung biopsy patients in 2015.
85 patients had biopsies. Mean age was 68.3yrs (SD 10.2). 61% were male. 74% attained a diagnosis. 8 patients (9%) had a pneumothorax (7 – small and managed conservatively, 1 – chest drain; 6 – discharged on the same day, 2 – admitted overnight).
93% of patients had spirometry pre-biopsy. Mean % predicted FEV1 was 78 (SD 22.0). 89% had an FEV1 >50% predicted. The mean % predicted FEV1 in pneumothorax patients was 102 (SD20.8), significantly higher than patients without at 77 (SD 21.0) (p=0.0128, unpaired t-test).
Pneumothorax rates were unrelated to needle size (≥20G vs <20G, p=0.191 χ2) or to number of biopsies (≤2 vs >2, p=0.897 χ2).
Patients with a pneumothorax had significantly better spirometry. In addition, biopsies were performed on few patients with an FEV1 <50% predicted despite guidance that biopsies can be performed as low as 35% predicted1. These findings may reflect a more cautious approach in those with poor lung function. However, CT biopsy is a safe test. Though some patients had a pneumothorax, few required admission or intervention. This may indicate a potential to perform this test on a wider range of patients.
1 Manhire, A et al. Thorax 2003:58:920–936.
- Copyright ©the authors 2016
