Cox et al identified risk factors associated with pneumothorax following transthoracic needle aspiration biopsy.
Imaging techniques used: both CT guided and fluroscopically guided
Needle size used: from 18 to 22 gauge
Risk factors associated with pneumothorax:
(2) traversing aerated lung
(3) size of the lesion
Percent with Pneumothorax
traversing aerated lung
no (on pleural surface)
size of lesion
0 - 1.0 cm
1.01 - 2.0 cm
2.01 - 3.0 cm
3.01 - 4.0 cm
4.01 - 5.0 cm
> 5 cm
• I would think that a smaller lesion would be less likely to be on the pleural surface, so crossing aerated lung is more likely.
• It looks as if there are 3 clusters for risk based on lesion size: 55-65%, 35-36% and 12-21%.
• The data does not appear to have been analyzed using univariate or multivariate analysis. Since the lowest rate of pneumothorax (13% for size > 5 cm) is less than 35% for emphysema absent, it would be interesting to look at the full data set to see if patients with small tumors predominated.
Findings not associated with pneumothorax rate:
(1) lesion location (which lobe)
(2) needle size
(3) number of pleural passes (smaller lesions probably take more passes)
(4) level of operator training
It would seem that several risk groups can be recognized:
(1) low risk (no risk factors) - no emphysema, size > 4 cm, no aerated lung passed
(2) high risk (all 3 risk factors) - emphysema, size <= 2 cm, aerated lung passed
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Purpose: To identify risk factors for pneumothorax in a patient undergoing transthoracic needle aspiration biopsy.
Objective: risk factors