Ground-Glass Opacities in the Access Route and Biopsy in Highly Perfused Dependent Areas of the Lungs as Risk Factors for Pulmonary Hemorrhage During CT-Guided Lung Biopsy: A Retrospective Study
Michael P. Brönnimann,
Leonie Manser,
Andreas Christe,
Johannes T. Heverhagen,
Bernhard Gebauer,
Timo A. Auer,
Dirk Schnapauff,
Federico Collettini,
Christophe Schroeder,
Patrick Dorn,
Tobias Gassenmaier,
Lukas Ebner,
Adrian T. Huber
Affiliations
Michael P. Brönnimann
Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010 Bern, Switzerland
Leonie Manser
Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010 Bern, Switzerland
Andreas Christe
Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010 Bern, Switzerland
Johannes T. Heverhagen
Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010 Bern, Switzerland
Bernhard Gebauer
Department of Radiology, Charité—Universitätsmedizin Augustenburger Platz 1, 13353 Berlin, Germany
Timo A. Auer
Department of Radiology, Charité—Universitätsmedizin Augustenburger Platz 1, 13353 Berlin, Germany
Dirk Schnapauff
Department of Radiology, Charité—Universitätsmedizin Augustenburger Platz 1, 13353 Berlin, Germany
Federico Collettini
Department of Radiology, Charité—Universitätsmedizin Augustenburger Platz 1, 13353 Berlin, Germany
Christophe Schroeder
Department of Radiology, Centre Hospitalier du Nord, 120 Av. Lucien Salentiny, Ettelbruck, 9080 Luxembourg, Luxembourg
Patrick Dorn
Department of Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 4, 3010 Bern, Switzerland
Tobias Gassenmaier
Department of Radiology and Nuclear Medicine, Cantonal Hospital Lucerne, University of Lucerne, 6000 Lucerne, Switzerland
Lukas Ebner
Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010 Bern, Switzerland
Adrian T. Huber
Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010 Bern, Switzerland
Background/Objectives: The risk of hemorrhage during CT-guided lung biopsy has not been systematically studied in cases where ground-glass opacities (GGO) are present in the access route or when biopsies are performed in highly perfused, dependent lung areas. While patient positioning has been studied for pneumothorax prevention, its role in minimizing hemorrhage risk remains unexplored. This study aimed to determine whether GGOs in the access route and biopsies in dependent lung areas are risk factors for pulmonary hemorrhage during CT-guided lung biopsy. Methods: A retrospective analysis was conducted on 115 CT-guided lung biopsies performed at a single center (2020–2023). Patients were categorized based on post-interventional hemorrhage exceeding 2 cm (Grade 2 or higher). We evaluated the presence of GGOs in the access route and biopsy location (dependent vs. non-dependent areas) using chi square, Fisher’s exact, and Mann–Whitney U tests. Univariate and multivariate logistic regression analyses were conducted to evaluate risk factors for pulmonary hemorrhage. Results: Pulmonary hemorrhage beyond 2 cm occurred in 30 of 115 patients (26%). GGOs in the access route were identified in 67% of these cases (p p = 0.03). Multivariable analysis showed that GGOs in the access route (OR 5.169, 95% CI 1.889–14.144, p = 0.001) and biopsies in dependent areas (OR 4.064, 95% CI 1.477–11.186, p < 0.001) independently increased hemorrhage risk. Conclusions: GGOs in the access route and dependent lung area biopsies are independent risk factors for hemorrhage during CT-guided lung biopsy.
