Analysis of factors influencing accuracy and complications in CT-guided lung biopsy

This study aimed to analyze factors influencing accuracy and complications in patients who underwent computed tomography (CT)-guided lung biopsy at our medical center.

This study included all 107 patients (72 men, 35 women; mean age, 69 years; range, 41-83 years) who underwent CT-guided lung biopsy between January 2006 and October 2009. CT fluoroscopy was used in 45.7% of cases. Final diagnosis, when surgical resection was performed, was histopathological diagnosis from the lung lesion specimen, and when resection was not performed, clinical diagnosis after ≥6 months of follow-up. The accuracy of lung biopsy was assessed by comparison of biopsy results and final diagnosis. The influence of factors on accuracy was statistically analyzed.

Accuracy of CT-guided lung biopsy was 89.4%. None of the factors, including lesion size, lesion depth from pleura, lesion location, patient position, final diagnosis, and use or non-use of CT fluoroscopy, had any significant influence on accuracy. The only complications were Grade 1 and 2 pneumothorax and Grade 1 pulmonary bleeding. The incidence of pneumothorax and bleeding was significantly increased with smaller lesion size and significantly increased with greater lesion depth. In patients with pulmonary emphysema, bleeding was significantly less (p = 0.022). When CT fluoroscopy was used, bleeding was significantly increased (p < 0.001).

None of the factors had any significant influence on accuracy. The incidence of pneumothorax and bleeding was affected by lesion size and lesion depth. When CT fluoroscopy was used, bleeding was significantly increased.