Percutaneous lung biopsy: should it be avoided or not?

Abstract

Introduction. Percutaneous core biopsy (PCB) is a minimally invasive, widely available and relatively safe procedure enabling pathological diagnosis in oncological patients. The objective of our study was to analyse the complication rates of PCBs between the lungs and other organs, for a better preprocedural evaluation. Material and methods. We performed a retrospective observational study of 558 PCBs, divided into: lung PCBs (n=355) and other PCBs (n=203). Descriptive statistics, the independent sample t-test, and Pearson correlation coefficient were used to analyse the statistical differences and relationships with the rate of complications. Results. The largest number of procedures was performed on the lungs (n=355), followed by breast (n=70) and liver (n=45) biopsies. The complication rate was 7.7% (n=43). The lung had a higher rate of complications (11.3%; n= 40), compared to 1.5% (n=3) from other PCBs. Lung PCBs correlate with complications (r(556) =.18, p < .001). The independent samples t-test was statistically significant, t(501) =5.2, p < 001. The lung PCBs were associated with a statistically significantly larger mean complication occurrence than the other PCBs. Cohen’s d was estimated at .37, which is a medium effect. The most common complication was pneumothorax (n=31), rate of 8.1% (n=29) from lung biopsies. CT-guidance (r(487) =.15, p =.001), repeated biopsies (r(538) =.17, p < .001), and INR (r(524) =-.10, p =.019) are correlated with complications. Conclusions. Lung biopsy is riskier than other biopsies and should be avoided if another biopsy, in the same pathological context, is available, to avoid unnecessary complications.

Keywords

• pneumothorax
• haemothorax
• ultrasound
• computer tomography
• image-guided