Computer tomography guided lung biopsy using interactive breath-hold control: a randomized study.

Area of Science:

• Pulmonary Medicine
• Radiology
• Interventional Procedures

Background:

• Computed tomography (CT)-guided lung biopsy is a common procedure for diagnosing lung lesions.
• Interactive breath-hold control (IBC) is a technique that may enhance CT-guided lung biopsy accuracy and safety.
• Previous studies have not conclusively demonstrated the benefits of IBC in a randomized setting.

Purpose of the Study:

• To evaluate the efficacy and safety of interactive breath-hold control (IBC) during CT-guided lung biopsy.
• To compare biopsy accuracy, procedure time, radiation exposure, and complication rates between patients undergoing biopsy with and without IBC.
• To identify predictors of pneumothorax in CT-guided lung biopsy.

Main Methods:

• A randomized controlled trial involving 407 patients undergoing CT-guided lung biopsy.
• Patients were randomized into two groups: one group with IBC (N=201) and a control group without IBC (N=206).
• Key outcomes assessed included biopsy accuracy, procedure duration, radiation dose, and incidence of pneumothorax. Predictors for pneumothorax were analyzed.

Main Results:

• Procedures utilizing IBC (N=130) did not demonstrate improved biopsy accuracy compared to those without IBC (N=171) (P=0.979).
• A significantly higher risk of pneumothorax was observed in the IBC group (P=0.022).
• Long needle dwell time (P=0.037) and smaller nodule size (P=0.001) were identified as predictors for pneumothorax.

Conclusions:

• Interactive breath-hold control (IBC) does not offer advantages for unselected patients undergoing CT-guided lung biopsy.
• The use of IBC did not enhance biopsy accuracy and was associated with an increased risk of pneumothorax.
• The findings suggest that IBC may not be beneficial in routine CT-guided lung biopsies, particularly considering the elevated complication risk.