[Failure factors in X-ray computed tomography-guided biopsy of pulmonary lesions: analysis of 103 consecutive biopsies].
OBJECTIVE
Percutaneous biopsy of pulmonary lesions with use of CT-guidance is well established and relatively safe. Reported accuracy rates are 64%-90% and major complications are rare. To determine the failure factors of CT-guided biopsy of lung lesions, we retrospectively analyzed 103 consecutive procedures.


METHODS
Fourteen characteristics of the biopsy procedure were analyzed, including size, location, skin-lesion and chest wall-lesion distances, operator experience, procedure type (histology and/or cytology), histologic definite diagnosis, and other.


RESULTS
Overall success rate was 88%. Success rate was correlated with the size of the lesion 4.3 +/- 2.9 cm for the positive results versus 2 +/- 1.2 cm for the negative results (p < 0.01). Skin- and chest wall-lesion distances were 5.8 +/- 2.2 and 1.5 +/- 1.8 respectively for positive results and 8.3 +/- 2.9 and 3.7 +/- 2.5 for negative results (p < 0.001). The overall complication rate for pneumothorax was 17%. Chest wall-lesion distances were 3.3 +/- 1.8 cm for complicated procedures and 1.5 +/- 1.9 cm for uncomplicated procedures (p < 0.001). No other factor was significantly correlated with the risk of pneumothorax.


CONCLUSIONS
Small lesion size, long skin- and chest wall-lesion distances are significant predictive failure factors. Long chest wall-lesion distance is significantly correlated with the complication rate for pneumothorax.
Guessous
K
K
Service de Radiologie, Hôpital Beaujon, Clichy.
Arrivé
L
L
Najmark
D
D
Zins
M
M
Groussard
O
O
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000009:adverse effects*; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D008175:Lung Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
Facteurs d'échec de la biopsie guidée par tomodensitométrie des lésions pulmonaires: analyse de 103 biopsies consécutives.