Computed Tomography-Guided Lung Biopsy: Does a Rural Hospital Do Better?

Area of Science:

• Pulmonology
• Radiology
• Oncology

Background:

• Percutaneous needle biopsy (PNB) is a standard diagnostic tool for lung cancer.
• Pneumothorax and bleeding are the most common PNB complications.
• Healthcare delivery can differ between rural and urban medical centers.

Purpose of the Study:

• To compare patient and lesion characteristics between urban and rural hospitals.
• To evaluate if lung PNB complication rates differ based on hospital setting (rural vs. urban).

Main Methods:

• Retrospective analysis of 561 patients undergoing lung biopsy at an urban (Tel Aviv Sourasky Medical Center) and a rural (Barzilai Medical Center) hospital.
• Complication rates assessed via chest X-ray 2 hours post-biopsy and computed tomography (CT) scans.
• Risk factors for pneumothorax analyzed, including distance from pleura, lesion size, and locus.

Main Results:

• Pneumothorax rates were similar between rural (12%) and urban (19%) centers (P=0.08).
• Distance from pleura was a risk factor for pneumothorax, but lesion size and locus were not.
• Bleeding rates were comparable: 32% in the rural center and 36% in the urban center (P=0.3).
• Immediate post-biopsy CT had a 95% negative predictive value for pneumothorax but cannot replace routine chest X-ray follow-up.

Conclusions:

• CT-guided percutaneous lung biopsies demonstrate comparable procedural characteristics and complication rates in rural and urban hospital settings.
• PNB is a reliable diagnostic method for lung cancer irrespective of the hospital's geographical location.