Safe Zone to Avoid Pneumothorax in a CT-Guided Lung Biopsy

Area of Science:

• Medical Imaging
• Thoracic Surgery
• Pulmonary Medicine

Background:

• Pneumothorax is a frequent complication following computed tomography (CT)-guided lung biopsies.
• Optimizing procedural parameters is crucial for patient safety during lung interventions.

Purpose of the Study:

• To identify the safe needle-pleura angle range during CT-guided lung biopsies.
• To correlate needle-pleura angle variations with the incidence of pneumothorax.

Main Methods:

• Retrospective analysis of 52 CT-guided lung biopsies performed between January 2020 and September 2022.
• Measurement of right and left needle angles and calculation of minimum delta (δmin) from a 90° angle.
• Statistical analysis (t-test) to correlate δmin with pneumothorax incidence.

Main Results:

• A total of 29 patients developed pneumothorax.
• Patients with a δmin < 10° had a 30% pneumothorax rate, versus 71.8% for those with δmin ≥ 10° (p = 0.0023).
• A significant increase in pneumothorax likelihood was observed when the needle angle deviated by more than 10° from perpendicular.

Conclusions:

• Deviations from a perpendicular needle-pleura angle increase pneumothorax risk.
• A needle-pleura angle between 80° and 100° represents a safe zone for CT-guided lung biopsies.
• Adhering to this angle range can significantly reduce the incidence of post-biopsy pneumothorax.