Incidence, severity and tolerability of pneumothorax following low‐dose CT‐guided lung biopsy in different severities of COPD

Zhou, Mi; Wang, Ting; Wei, Dong; Zhu, Yong; Jiang, Yudan; Cui, Zhe; Jiang, Li; Chen, Hong; Guo, Shuliang; Yang, Li

doi:10.1111/crj.13272

“…In this study, complications of multislice spiral CT-guided lung biopsy were observed, and the results showed that there was no statistical significance in the incidence of pneumothorax in groups of different sizes of pulmonary nodules. According to relevant reports, the incidence of pneumothorax of CT-guided transthoracic lung biopsy is 15.4%~42.0%, only 4.3%~7.3% patients need thoracic catheter drainage, and the incidence of hemoptysis is 0.5%~14.4%, most of which do not need intervention [ 20 , 21 ]. The common risk factors of pneumothorax include long puncture path, multiple crossing of pleura, and small lesion [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety Analysis of Multislice Spiral CT-Guided Transthoracic Lung Biopsy in the Diagnosis of Pulmonary Nodules of Different Sizes

Liu

¹

,

Xiao

²

,

Xu

³

et al. 2022

Computational and Mathematical Methods in Medicine

View full text Add to dashboard Cite

Objective. This study is aimed at investigating the efficacy and safety of multislice spiral CT-guided transthoracic lung biopsy in the diagnosis of pulmonary nodules of different sizes. Methods. Data of 78 patients with pulmonary nodules who underwent CT-guided transthoracic lung biopsy in our hospital from January 2020 to December 2021 were retrospectively analyzed, and they were divided into the small nodules group ( n = 12 ), medium nodules group ( n = 35 ), and large nodules group ( n = 31 ) according to the diameter of pulmonary nodules. The results of puncture biopsy and final diagnosis of pulmonary nodules of different sizes were compared. The incidence of complications in patients with pulmonary nodules of different sizes was compared. Univariate analysis was used to compare the incidence of complications in 78 patients. Logistic multiple regression analysis was used to analyze the independent risk factors of pneumothorax in patients with pulmonary nodule puncture. Logistic multiple regression analysis was used to analyze the independent risk factors of pulmonary hemorrhage in patients with pulmonary nodule puncture. Results. The diagnostic accuracy, sensitivity, and specificity were 83.33%, 100.00%, and 77.78% in small nodules group. The diagnostic accuracy, sensitivity, and specificity of medium nodules group were 85.71%, 100.00%, and 73.68%, respectively. The diagnostic accuracy, sensitivity, and specificity of large nodules group were 93.55%, 100.00%, and 33.33%, respectively. There was no significant difference in the incidence of pneumothorax among the three groups ( P > 0.05 ). The incidence of pulmonary hemorrhage in small nodule group was higher than that in the medium nodule group and large nodule group, and the difference was statistically significant ( P < 0.05 ). There was no significant difference in the incidence of total complications among the three groups ( P > 0.05 ). There were statistically significant differences in clinical data such as the needle tract length, the puncture position, and the distance of the puncture needle passing through the lung tissue in patients with or without pneumothorax ( P < 0.05 ). There were statistically significant differences in needle tract length, distance of puncture needle passing through lung tissue, and size of pulmonary nodules in patients with or without pulmonary hemorrhage ( P > 0.05 ). Logistic multivariate analysis showed that needle tract length ≤ 50 mm , lateral decubitus position, and the distance of puncture needle passing through lung tissue ≥ 14 mm were independent risk factors for pneumothorax after puncture in patients with pulmonary nodules ( P < 0.05 ). The needle tract length > 50 mm , the distance of puncture needle passing through lung tissue ≥ 14 mm , and small nodules (pulmonary nodules diameter ≤ 10 mm ) were independent risk factors for pulmonary hemorrhage after puncture in patients with pulmonary nodules ( P < 0.05 ). Conclusion. Multislice spiral CT-guided transthoracic lung biopsy is effective in diagnosing pulmonary nodules of different sizes.

show abstract

“…Many recent studies have focused on the implementation of ULD protocols during percutaneous lung biopsies under CT guidance [21][22][23][24][25][26][27]. One of the most robust prospective randomised studies was published by Fu et al, demonstrating a ten-fold decrease of mean DLP (36.0 ± 14.1 mGy cm vs. 361.8 ± 108.0 mGy cm, p < 0.001) and effective dose (0.5 ± 0.2 mSv vs. 5.1 ± 1.5 mSv, p < 0.001) with comparable diagnostic accuracy.…”

Section: Discussionmentioning

confidence: 99%

An ultra-low-dose protocol for computed tomography-guided lung radiofrequency ablations

Golin¹,

Izaaryene²,

Dassa³

et al. 2022

J. Radiol. Prot.

0

View full text Add to dashboard Cite

Purpose To evaluate safetey and efficacy of an ultra low dose (ULD) protocol implementation during lung radiofrequency ablations. Methods All patients who underwent a lung RFA were consecutively and retrospectively included between November 2017 and January 2021. 30 patiens were treated with a historical standard protocol (SP), 31 with an ULD protocol. Patient characteristics, dose indicators, technical efficacy (minimal margin MM, recurrence during the follow up) and complications (pneumothorax, alveolar hemorrhage, hemoptysis) were recorded. Results 61 patients were included (median age, 65 [54. 73], 33 women). There was no significant difference in the characteristics of the patients according to the type of protocol, except for the type of anesthesia. Even if the number of helical acquisitions had not significantly changed, all the dose indicators significantly decreased by 1.5-fold to 3-fold. The median dose-length-product and effective dose were respectively 465mGy.cm [315; 554] and 6.5mSv [4.4; 7.8] in the SP group versus 178 mGy.cm [154; 267] and 2.5mSv [2.2; 3.7] in the ULD group, (p<.001). The ULD group presented a lower intra-operator variability and a better inter-operator alignment. The MM were not significantly different in the 2 groups (4.6mm versus 5mm, p=.16). One local recurrence was observed in each group, at 8 months for the SP and at one year for the ULD group (p=1). No significant difference was found in the complications rates. Conclusion Implmenting an ultra-low dose protocol during lung RFA may allow with the same efficacy, a reduction of dose indicators, intra- and inter-operator alignments, without increasing complications rates.

show abstract

“…The convolutional neural network model (CNN) [ 19 ] and residual network model (ResNet) [ 20 ] were introduced for comparison with the improved DRCNN model that is proposed in this research.…”

Section: Methodsmentioning

confidence: 99%

Deep Learning‐Based Computed Tomography Features in Evaluating Early Screening and Risk Factors for Chronic Obstructive Pulmonary Disease

Zhang

¹

,

Liu

²

,

Cao

³

et al. 2022

Contrast Media & Molecular Imaging

2

0

View full text Add to dashboard Cite

This research aimed to investigate the diagnostic effect of computed tomography (CT) images based on a deep learning double residual convolution neural network (DRCNN) model on chronic obstructive pulmonary disease (COPD) and the related risk factors for COPD. The questionnaire survey was conducted among 980 permanent residents aged ≥ 40 years old. Among them, 84 patients who were diagnosed with COPD and volunteered to participate in the experiment and 25 healthy people were selected as the research subjects, and all of them underwent CT imaging scans. At the same time, an image noise reduction model based on the DRCNN was proposed to process CT images. The results showed that 84 of 980 subjects were diagnosed with COPD, and the overall prevalence of COPD in this epidemiological survey was 8.57%. Multivariate logistic regression model analysis showed that the regression coefficients of COPD with age, family history of COPD, and smoking were 0.557, 0.513, and 0.717, respectively ( P < 0.05 ). The diagnostic sensitivity, specificity, and accuracy of DRCNN-based CT for COPD were greatly superior to those of single CT and the difference was considerable ( P < 0.05 ). In summary, advanced age, family history of COPD, and smoking were independent risk factors for COPD. CT based on the DRCNN model can improve the diagnostic accuracy of simple CT images for COPD and has good performance in the early screening of COPD.

show abstract

Incidence, severity and tolerability of pneumothorax following low‐dose CT‐guided lung biopsy in different severities of COPD

Cited by 8 publications

References 23 publications

Efficacy and Safety Analysis of Multislice Spiral CT-Guided Transthoracic Lung Biopsy in the Diagnosis of Pulmonary Nodules of Different Sizes

Efficacy and Safety Analysis of Multislice Spiral CT-Guided Transthoracic Lung Biopsy in the Diagnosis of Pulmonary Nodules of Different Sizes

An ultra-low-dose protocol for computed tomography-guided lung radiofrequency ablations

Deep Learning‐Based Computed Tomography Features in Evaluating Early Screening and Risk Factors for Chronic Obstructive Pulmonary Disease

Contact Info

Product

Resources

About