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Computer tomography guided lung biopsy using interactive breath-hold control: a randomized study
Haseem Ashraf1,2,3, Shella Krag-Andersen1, Matiullah Naqibullah1
1Department of Respiratory Medicine, Gentofte University Hospital, Hellerup, Denmark.
Background:
Interactive breath-hold control (IBC) may improve the accuracy and decrease the complication rate of computed tomography (CT)-guided lung biopsy, but this presumption has not been proven in a randomized study.
Methods:
Patients admitted for CT-guided lung biopsy were randomized to biopsy either with (N=201) or without (N=206) IBC. Biopsy accuracy, procedure time, radiation, and complications were compared in the two groups. Predictors for pneumothorax were analyzed.
Results:
Procedures performed with the use of IBC (N=130) did not show higher biopsy accuracy (P=0.979) but were associated with a higher risk of pneumothorax (P=0.022) compared to procedures without the use of IBC (N=171). Overall, 50% of the biopsies were malignant, 13% were benign, and 33% were inconclusive (4% missing). Long needle time (P=0.037) and small nodule size (P=0.001) were predictors of pneumothorax.
Conclusions:
The use of IBC for CT-guided lung biopsy was not an advantage for unselected patients in our care, since it did not improve the biopsy accuracy and the risk of pneumothorax was increased.
