Objectifs
To identify predictors of pneumothorax following CT-guided lung biopsy and determine how risk stratification may support safer patient selection, procedural planning, and post-biopsy management.
Matériel et méthode
We conducted a retrospective study of patients who underwent CT-guided percutaneous lung biopsy in our institution. Demographic characteristics, imaging features, and procedural variables were collected, including lesion size, pleura-to-lesion distance, emphysema along the needle path, trajectory complexity, and number of pleural transgressions.
Pneumothorax occurrence and requirement for chest tube placement were recorded. Results from our cohort were interpreted in light of contemporary literature on complication mechanisms and prevention.
Résultats
- Pneumothorax was the most frequent complication observed in our series. This finding aligns with large published cohorts reporting incidences typically ranging from 15% to 25%, with drainage required in approximately 4-6% of procedures.
- In our population, longer pleura-to-lesion distance and the presence of emphysema showed strong association with pneumothorax, in agreement with previously identified anatomical vulnerability factors.
- Smaller lesion size and complex trajectories also appeared to increase risk.
- In contrast, procedural variables such as the number of samples obtained demonstrated limited influence, supporting recent evidence suggesting that patient and lung characteristics may play a greater role than biopsy aggressiveness.
- Together, these findings emphasize that pre-procedural imaging can help anticipate complications and guide adapted strategies for higher-risk individuals.
Conclusion
Recognition of pneumothorax predictors enables radiologists to move from reactive management toward proactive risk anticipation. Integrating anatomical and patient-related factors into decision-making may improve safety, optimize monitoring, and refine patient counseling.
- Pneumothorax remains the most common complication after CT-guided lung biopsy.
- Emphysema and longer intrapulmonary needle paths are major determinants of risk.
- Anticipating vulnerability can guide safer procedural strategies and follow-up.