Chest Imaging - Original Article
Risk factors for hemoptysis complicating 17-18 gauge CT-guided transthoracic needle core biopsy: multivariate analysis of 249 procedures
Department of Radiology, Paris Descartes University, Sorbonne Paris Cité Groupe Hospitalier Cochin-Hotel Dieu, Paris, France
Department of Biostatistics and Epidemiology, Paris Descartes University, Sorbonne Paris Cité Groupe Hospitalier Cochin-Hotel Dieu, Paris, France
Department of Thoracic Surgery, Paris Descartes University, Sorbonne Paris Cité Groupe Hospitalier Cochin-Hotel Dieu, Paris, France
Diagn Interv Radiol ; : -
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Purpose: To identify modifiable and non-modifiable risk factors for hemoptysis complicating computed tomography (CT)-guided transthoracic needle biopsy.
Methods: All procedures performed in our institution from November 2013 to May 2015 were reviewed. Hemoptysis was classified as mild if limited to hemoptoic sputum, and otherwise as abundant. Presence of intraalveolar hemorrhage on post-biopsy CT images was also evaluated. Patient- and lesion-related variables were considered non-modifiable, while procedure-related variables were considered modifiable. Univariate and multivariate analysis were performed.
Results: Two hundred and forty-nine procedures were evaluated. Hemoptysis and alveolar hemorrhage occurred in respectively 18% and 58% of procedures and were abundant or significant in respectively 8% and 17% of procedures. Concordance between the occurrence of significant alveolar hemorrhage (grade ≥ 2) and hemoptysis was poor (kappa=0.28; 95%CI [0.16-0.40]). In multivariate analysis, female gender (P = 0.008), a longer transpulmonary needle path (P = 0.014) and smaller lesion size (P = 0.044) were independent risk factors for hemoptysis. Transpulmonary needle-path length was the only risk factor for abundant hemoptysis with borderline statistical significance (P = 0.049).
Conclusion: The transpulmonary needle path should be as short as possible to reduce the risk of abundant hemoptysis during CT-guided transthoracic needle biopsy.