Novel Risk Factors of Pulmonary Hemorrhage Complicating CT-Guided Lung Biopsy in Coaxial Technique

Christophe Schroeder,

Published on: 2021-02-03


Objectives: To evaluate the frequency and severity of the pulmonary parenchymal hemorrhage after coaxial transthoracic needle biopsy of the lung, according to procedural factors not yet described in the literature. This study aimed to determine whether the choice of the coaxial biopsy technology, patient positioning, and the lesion dignity are three new variables influencing the risk of parenchymal hemorrhage after coaxial biopsies of the lung.
Methods: Records from 117 patients who underwent transthoracic needle biopsies of the lung between January 2018 and April 2020 have been retrospectively reviewed. The primary outcome was pulmonary hemorrhage. A grading system has been used to classify pulmonary parenchymal hemorrhage: Grade 0 - Grade 3. Three novel patient, technique, and lesion-related variables were evaluated as predictors of pulmonary hemorrhage: coaxial biopsy technology, patient positioning, and lesion dignity.
Results: Out of the 117 patients, 18 (15.4%) patients with cutting coaxial biopsy technology, versus 29 (24.8%) patients with full core coaxial technology showed significant hemorrhage on the post-biopsy control scans (95% CI 0.06-0.33, p<0.0001).
No significant difference in pulmonary hemorrhage between benign and malignant histological diagnosis (95% CI: 0.84-4.44, p=0.1199) and prone or supine patient positioning (95% CI: 0.57-2.57, p= 0.6232) was found.
Conclusions: The incidence and severity of pulmonary hemorrhage depend on the coaxial biopsy technology used; being higher in patients undergoing a biopsy with full-core technology and lower after the use of cutting technology. No significant correlation between parenchymal pulmonary hemorrhage and patient positioning or lesion dignity was established in this prognostic study.

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