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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.

Annals of Translational Medicine
|July 15, 2017
PubMed
Summary
This summary is machine-generated.

Interactive breath-hold control (IBC) did not improve computed tomography-guided lung biopsy accuracy. This technique was associated with an increased risk of pneumothorax in unselected patients.

Keywords:
Computed tomography (CT)-guided lung biopsybreath holdingnodulepneumothorax

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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.