Lung radiodensity along the needle passage is a quantitative predictor of pneumothorax after CT-guided percutaneous core needle biopsy.

AIM: To analyse whether the lowest value of lung radiodensity along the passage of the biopsy needle is a quantitative predictor of pneumothorax.

MATERIALS AND METHODS: CT-guided percutaneous core needle biopsy (PCNB) procedures performed at Zhongnan Hospital were analysed retrospectively. Age, gender, lesion size, lesion depth, lesion location, patient position, number of passages, needle pleural angle, pulmonary bleeding, and lung radiodensity along the needle passage were collected and classified by the extent of pneumothorax. Univariate analysis and multiple logistic regression analysis were assessed to explore the independent risk factors for pneumothorax.

RESULTS: Six hundred and seventy-seven cases were included in the study, including 456 males and 221 females. Pneumothorax occurred in 40.18% of cases, of which 82.4% were mild, 14% were moderate, and 3.7% were severe. Univariate and multivariate analysis showed that lesion size ≤2 cm (p=0.002), two or more passages (p=0.033), and lung radiodensity of -850 HU or less (p≤0.001) were independent risk factors for pneumothorax; bleeding (p<0.001) was a protective factor for pneumothorax.

CONCLUSIONS: The lowest value of lung radiodensity along the needle passage was a quantitative predictor of pneumothorax. A value of -850 HU or less was an independent risk factor for pneumothorax. As the value decreased, there was a higher risk of occurrence of more severe pneumothorax.