title: Development of a prediction model and risk score for procedure-related complications in patients undergoing percutaneous computed tomography-guided lung biopsy.
abstract: OBJECTIVE
  To propose a risk score predicting the potential occurrence of procedure-related complications in patients undergoing computed tomography (CT)-guided lung biopsy.
  
  
  METHODS
  Institution review board approval was obtained. A total of 342 CT-guided lung biopsies were retrospectively evaluated taking into account procedure-related complications and associated risk factors, including patient gender and age, previous radiation therapy (RT) and/or chemotherapy (CHT), lesion size, depth and location, incomplete pulmonary fissures, associated diffuse lung diseases, previous pneumothorax (PNX), lung volumes, punctured fissures, thoracic access, needle size and operator experience. Complications were assessed on chest X-ray and/or CT scans. Stepwise logistic regression was used to identify risk factors, to evaluate their correlation with procedure-related complications and to calculate models of risk (MoRs).
  
  
  RESULTS
  PNX requiring chest tube placement occurred in 39 patients (11.4%), high-grade pulmonary parenchymal haemorrhage occurred in 62 patients (18.1%) and haemothorax occurred in 12 patients (3.5%). Risk factors increasing the incidence of complications were lesion size (P = 0.01), lesion depth (P = 0.01) and incomplete pulmonary fissures (P = 0.01); previous chemo-radiation therapy was correlated to a lower incidence of complications (P = 0.01). MoR for PNX was as follows: risk base line = 60%; age = +0.15%/year; punctured fissures = +20%; incomplete fissures = +9%; previous CHT/RT = -10%. MoR for parenchymal haemorrhage was as follows: risk base line = 20%, lesion depth = +0.8%/mm; age = +0.25%/year; incomplete fissures = +15%. MoR for haemothorax was as follows: risk base line = 1%; previous PNX = +20%; incomplete fissures = 7%; both previous PNX and incomplete fissures = +67%.
  
  
  CONCLUSIONS
  This study provides MoRs to predict the risk of complications in patients undergoing CT-guided percutaneous lung biopsies.
authors.affiliation: Department of Radiological, Oncological and Anatomopathological Sciences - Radiology, 'Sapienza' University of Rome, Rome, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Anzidei
authors.affiliation: Department of Radiological, Oncological and Anatomopathological Sciences - Radiology, 'Sapienza' University of Rome, Rome, Italy beatrice.sacconi@fastwebnet.it.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Sacconi
authors.affiliation: Institute of Nuclear Medicine, University College London Hospital, London, UK.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fraioli
authors.affiliation: Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, Monserrato, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Saba
authors.affiliation: Department of Radiological, Oncological and Anatomopathological Sciences - Radiology, 'Sapienza' University of Rome, Rome, Italy.
authors.forename: Pierleone
authors.initials: P
authors.lastname: Lucatelli
authors.affiliation: Department of Radiological, Oncological and Anatomopathological Sciences - Radiology, 'Sapienza' University of Rome, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Napoli
authors.affiliation: Department of Radiological, Oncological and Anatomopathological Sciences - Oncology, 'Sapienza' University of Rome, Rome, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Longo
authors.affiliation: Department of Radiological, Oncological and Anatomopathological Sciences- Pathology, 'Sapienza' University of Rome, Rome, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Vitolo
authors.affiliation: Department of Thoracic Surgery, 'Sapienza' University of Rome, Rome, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Venuta
authors.affiliation: Department of Thoracic Surgery, 'Sapienza' University of Rome, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Anile
authors.affiliation: Department of Thoracic Surgery, 'Sapienza' University of Rome, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Diso
authors.affiliation: Department of Radiological, Oncological and Anatomopathological Sciences - Radiology, 'Sapienza' University of Rome, Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Bezzi
authors.affiliation: Department of Radiological, Oncological and Anatomopathological Sciences - Radiology, 'Sapienza' University of Rome, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Catalano
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects* / Q000379:methods; D008168:Lung / Q000473:pathology*; D008171:Lung Diseases / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015641:Radiography, Interventional / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012737:Sex Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000379:methods; D055815:Young Adult
keywords: CT-guided lung biopsy; Complications; Lung tumour; Pneumothorax; Risk score