Background Percutaneous CT-guided lung core-needle biopsy is a frequently performed and generally safe procedure. However, with advances in the management of lung cancer, there is a need for a greater amount of tissue for tumor genomic profiling and characterization. Purpose To determine whether the number of core samples obtained with percutaneous CT-guided lung biopsy is associated with postprocedural complications. Materials and Methods This retrospective study included consecutive patients who underwent percutaneous CT-guided coaxial lung core-needle biopsy for suspected primary lung cancer between November 2012 and August 2023 at an academic tertiary referral hospital. Patient data from medical records were collected, including demographics, lesion size and distance from pleura, and number of obtained biopsy samples. Postprocedural complications of pneumothorax, chest tube placement, perilesional hemorrhage, and hemoptysis were recorded. Multivariable logistic regression models were used to assess whether the number of cores was a predictive factor for lung biopsy complications. Results A total of 827 patients (mean age, 70.9 years ± 9.6 [SD]; 474 [57.3%] female patients) were included. The median lesion size was 22 mm (IQR, 15-34 mm), with 517 of 827 (62.5%) patients diagnosed with lung adenocarcinoma. Pneumothorax was noted in 171 of 827 (20.7%) patients, with a chest tube placed in 32 of 827 (3.9%), perilesional hemorrhage in 353 of 827 (42.7%), and hemoptysis in 20 of 827 (2.4%) patients. The median number of samples obtained was four (range, one to 12). Multivariable analysis showed no evidence of an association between the number of core samples obtained and any complications: pneumothorax (coefficient, -0.02; P = .81), chest tube (coefficient, 0.18; P = .26), perilesional hemorrhage (coefficient, -0.03; P = .63), or hemoptysis (coefficient, -0.10; P = .60). Conclusion In patients suspected of having lung cancer who underwent percutaneous CT-guided coaxial lung core biopsy, there was no evidence of an association between the number of core biopsy samples obtained and any postprocedural complications. © RSNA, 2024 See also the editorial by Zuckerman in this issue.

中文翻译：

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CT 引导下同轴肺活检：核心数量和与并发症的相关性。


背景 经皮 CT 引导下肺空心针穿刺活检是一种经常进行且通常安全的手术。然而，随着肺癌管理的进步，需要更多的组织用于肿瘤基因组分析和表征。目的 确定经皮 CT 引导肺活检获得的核心样本数量是否与术后并发症相关。材料和方法 本回顾性研究纳入了 2012 年 11 月至 2023年8月在学术三级转诊医院接受经皮 CT 引导下同轴肺空心针活检的疑似原发性肺癌的连续患者。从病历中收集患者数据，包括人口统计学、病灶大小和与胸膜的距离，以及获得的活检样本数量。记录气胸、胸管置入、病灶周围出血和咯血等术后并发症。采用多变量 logistic 回归模型评估核心数量是否是肺活检并发症的预测因素。结果 共纳入 827 例患者 （平均年龄 70.9 岁 ± 9.6 [SD];474 [57.3%] 女性患者）。中位病灶大小为 22 mm （IQR， 15-34 mm），827 例患者中有 517 例 （62.5%） 诊断为肺腺癌。827 例患者中有 171 例 （20.7%） 出现气胸，827 例中有 32 例 （3.9%） 放置了胸管，827 例中有 353 例 （42.7%） 出现病灶周围出血，827 例患者中有 20 例 （2.4%） 出现咯血。获得的样本数中位数为 4 （范围，1 到 12）。多变量分析显示，没有证据表明获得的核心样本数量与任何并发症之间存在关联：气胸（系数，-0.02;P = .81）、胸管 （系数，0.18;P = .26）、病灶周围出血 （系数，-0.03;P = .63）或咯血（系数，-0.10;P = .60）。结论 在接受经皮 CT 引导下同轴肺核心活检的疑似肺癌患者中，没有证据表明获得的粗肺活检样本数量与任何术后并发症之间存在关联。© RSNA，2024 另见 Zuckerman 在本期的社论。