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Iatrogenic pneumothorax after CT-guided lung biopsy
Keerthana Balaji1, Ganesh Kumar Balaji Sajjala Chokkalingeswara Rao2, Simon Høj3
1Department of Pulmonary and Infectious Medicine, Copenhagen University Hospital - Bispebjerg Hospital.
Danish Medical Journal
|March 3, 2026
Summary
Iatrogenic pneumothorax (PTX) is common after CT-guided lung biopsy. Male sex is a risk factor for PTX, while lesion depth influences the need for drainage, aiding procedural planning.
Area of Science:
- Pulmonology
- Radiology
- Thoracic Surgery
Background:
- CT-guided lung biopsy is crucial for diagnosing lung abnormalities.
- Iatrogenic pneumothorax (PTX) is a frequent complication, lacking specific management guidelines.
- Limited evidence exists on risk factors and management for post-biopsy PTX.
Purpose of the Study:
- To identify risk factors for PTX after CT-guided lung biopsy.
- To determine predictors for chest tube drainage in patients with PTX.
- To inform risk stratification and procedural planning for CT-guided lung biopsies.
Main Methods:
- Retrospective observational study of 267 patients undergoing CT-guided lung biopsy.
- Data collected: demographics, smoking status, lung function, lesion characteristics, and diagnosis.
- Primary outcome: PTX within 72 hours; Secondary outcome: need for chest tube drainage.
Main Results:
- PTX occurred in 30% of patients; male sex was an independent predictor (OR=1.93).
- No association found between PTX and age, smoking, lesion location, or lung function.
- Lesion distance to pleura was greater in patients requiring drainage (44 mm vs 28 mm).
Conclusions:
- Iatrogenic PTX is a significant complication of CT-guided lung biopsy.
- Male sex is a predictor for developing PTX.
- Lesion depth is a predictor for requiring chest tube drainage, guiding procedural decisions.
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