Usefulness of CT-Guided Percutaneous Transthoracic Needle Lung Biopsies in Patients with Suspected Pulmonary Infection

• Published in: Korean journal of radiology Vol. 21; no. 5; pp. 526 - 536
• Main Authors: Kim, Junghoon, Lee, Kyung Hee, Cho, Jun Yeun, Kim, Jihang, Shin, Yoon Joo, Lee, Kyung Won
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Radiology 01.05.2020; 대한영상의학회
• Subjects: Biopsy; Bronchoscopy; Histopathology; Infections; Laboratories; Medical records; Organisms; Patients; Pneumothorax; Thoracic Imaging; 방사선과학; United States > US; Infection; Image-guided biopsy; Lung; Multidetector computed tomography
• ISSN: 1229-6929; 2005-8330; 2005-8330
• DOI: 10.3348/kjr.2019.0492

This study aimed to evaluate the clinical benefits and risks of CT-guided percutaneous transthoracic needle lung biopsies (PTNBs) in patients with a suspected pulmonary infection. This study included 351 CT-guided PTNBs performed in 342 patients (mean age, 58.9 years [range, 17-91 years]) with suspected pulmonary infection from January 2010 to December 2016. The proportion of biopsies that revealed the causative organism for pulmonary infection and that influenced patient's treatment were measured. Multivariate analyses were performed to identify factors associated with PTNB that revealed the causative organism or affected the treatment. Finally, the complication rate was measured. CT-guided PTNB revealed the causative organism in 32.5% of biopsies (114/351). The presence of necrotic components in the lesion (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1-2.7; = 0.028), suspected pulmonary tuberculosis (OR, 2.0; 95% CI, 1.2-3.5; = 0.010), and fine needle aspiration (OR, 2.5; 95% CI, 1.1-5.8; = 0.037) were factors associated with biopsies that revealed the causative organism. PTNB influenced patient's treatment in 40.7% (143/351) of biopsies. The absence of leukocytosis (OR, 1.9; 95% CI, 1.0-3.7; = 0.049), presence of a necrotic component in the lesion (OR, 2.4; 95% CI, 1.5-3.8; < 0.001), and suspected tuberculosis (OR, 1.7; 95% CI, 1.0-2.8; = 0.040) were factors associated with biopsies that influenced the treatment. The overall complication rate of PTNB was 19% (65/351). In patients with suspected pulmonary infection, approximately 30-40% of CT-guided PTNBs revealed the causative organism or affected the treatment. The complication rate of PTNB for suspected pulmonary infection was relatively low.