Correlation Between Distance From Lesions to Pleura and Complications in CT-Guided Lung Biopsy: A Cross-Sectional Study in Vietnam.

INTRODUCTION

CT-guided transthoracic needle biopsy (CT-TTNB) is an essential diagnostic procedure but is associated with complications such as pneumothorax and pulmonary hemorrhage. The distance from the lesion to the pleura (traversed parenchymal distance) is widely recognized as a major risk factor. This study aims to evaluate the correlation between the traversed lung parenchymal distance and post-CT-TTNB complications, and to identify independent predictors for these complications.

METHODS

A retrospective cross-sectional study was conducted on 226 patients who underwent CT-TTNB. Data on demographics, lesion characteristics, and procedure-related factors (traversed parenchymal distance, number of biopsy samples) were collected. Multivariable logistic regression analysis was used to identify independent predictors for pneumothorax and pulmonary hemorrhage.

RESULTS

The overall complication rate was 47.35%, with pneumothorax at 29.2% and pulmonary hemorrhage at 32.74%. Multivariable analysis showed that statistically significant independent predictors for pneumothorax were male gender (adjusted odds ratio [aOR] = 3.78; 95% confidence interval [CI]: 1.81-7.89; p < 0.001) and the number of biopsy samples (aOR = 0.65; 95% CI: 0.45-0.94; p = 0.022). The traversed lung parenchymal distance was not a statistically significant independent predictor for either pneumothorax (p = 0.251) or pulmonary hemorrhage.

CONCLUSIONS

In this study population, male gender and the number of biopsy samples were significantly associated with the risk of pneumothorax. The traversed lung parenchymal distance did not emerge as an independent predictor in the multivariable model. These findings challenge the traditional view and emphasize the need for a multifactorial risk assessment model rather than relying on a single parameter.