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Article

Lung Density in the Trajectory Path—A Strong Indicator of Patients Sustaining a Pneumothorax during CT-Guided Lung Biopsy

by
Charbel Saade
1,†,
Salah Zien-El-Dine
2,†,
Youssef Ghosn
3,
Nadine Hamieh
3,
Batoul Dekmak
3,
Diamond Ghieh
3,
Gilbert Maroun
3 and
Fadi El-Merhi
3,4,*
1
Department of Medical Imaging Sciences, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
2
Department of Respiratory Medicine, American University of Beirut, Beirut, Lebanon
3
Department of Diagnostic Radiology, American University of Beirut, Beirut, Lebanon
4
Department of Radiology, Brigham and Women’s Hospital and Dana Farber Cancer Institute, Boston, MA, USA
*
Author to whom correspondence should be addressed.
Equal contribution.
Adv. Respir. Med. 2020, 88(2), 108-115; https://doi.org/10.5603/ARM.2020.0084
Submission received: 5 November 2019 / Revised: 13 February 2020 / Accepted: 13 February 2020 / Published: 30 April 2020

Abstract

Introduction: The purpose is to evaluate the prognostic significance of lung parenchymal density during percutaneous coaxial cutting needle lung biopsy (PNLB). Materials and methods: Retrospective analysis of 179 consecutive patients (106 males, 73 females; mean age 59.16 ± 16.34 years) undergoing PNLB was included. Mean lobar parenchymal lung density, mean densities anterior to the lesion and posterior to the chest wall in the needle trajectory path were measured in HU. Lesion location and needle trajectory were also measured. Fisher’s exact test and Chi-square test were conducted to analyze the categorical variables. ANOVA test was done to examine continuous and normally distributed variables. Statistical significance was considered when p < 0.05. Results: Mean lobar parenchymal lung density (p < 0.05) and mean parenchymal lung density relative to the needle trajectory path were below -800 HU in patients who sustained a pneumothorax. Increase in the number of pleural passes was significantly associated with the risk of patients having pneumothorax (p < 0.05). The mean distance from the skin to the lesion and needle trajectory angle were not statistically different among patients with and without pneumothorax (p > 0.05). Conclusion: Lobar parenchymal density and lung parenchymal density anterior to the lesion and posterior to the chest wall in the needle trajectory path could be used as predicting parameters in patients undergoing PNLB who sustained a pneumothorax. These findings can help interventional radiologist further assess risk of pneumothorax when preforming such procedure.
Keywords: lung biopsy; iatrogenic pneumothorax; lung parenchymal density; parenchymal mass; needle trajectory lung biopsy; iatrogenic pneumothorax; lung parenchymal density; parenchymal mass; needle trajectory

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MDPI and ACS Style

Saade, C.; Zien-El-Dine, S.; Ghosn, Y.; Hamieh, N.; Dekmak, B.; Ghieh, D.; Maroun, G.; El-Merhi, F. Lung Density in the Trajectory Path—A Strong Indicator of Patients Sustaining a Pneumothorax during CT-Guided Lung Biopsy. Adv. Respir. Med. 2020, 88, 108-115. https://doi.org/10.5603/ARM.2020.0084

AMA Style

Saade C, Zien-El-Dine S, Ghosn Y, Hamieh N, Dekmak B, Ghieh D, Maroun G, El-Merhi F. Lung Density in the Trajectory Path—A Strong Indicator of Patients Sustaining a Pneumothorax during CT-Guided Lung Biopsy. Advances in Respiratory Medicine. 2020; 88(2):108-115. https://doi.org/10.5603/ARM.2020.0084

Chicago/Turabian Style

Saade, Charbel, Salah Zien-El-Dine, Youssef Ghosn, Nadine Hamieh, Batoul Dekmak, Diamond Ghieh, Gilbert Maroun, and Fadi El-Merhi. 2020. "Lung Density in the Trajectory Path—A Strong Indicator of Patients Sustaining a Pneumothorax during CT-Guided Lung Biopsy" Advances in Respiratory Medicine 88, no. 2: 108-115. https://doi.org/10.5603/ARM.2020.0084

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