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Rapid Needle-Out Patient-Rollover Time after Percutaneous CT-guided Transthoracic Biopsy of Lung Nodules: Effect on Pneumothorax Rate.
MedLine Citation:
PMID:  22106349     Owner:  NLM     Status:  Publisher    
Purpose:To assess the effect of a rapid needle-out patient-rollover time approach on the rate of pneumothorax after computed tomography (CT)-guided transthoracic needle biopsy of pulmonary nodules.Materials and Methods:The institutional review board approved the study, and all patients gave written informed consent. Between January 2008 and December 2009, percutaneous CT-guided lung biopsy was performed in 201 patients. Eighty-one biopsies were performed without (group 1) and 120 were performed with (group 2) a rapid needle-out patient-rollover time approach (defined as the time between removal of the biopsy needle and placing the patient biopsy-side down). Multivariate analysis was performed between groups for risk factors for pneumothorax, including patient demographic characteristics, lesion characteristics, and biopsy technique.Results:Mean rapid needle-out patient-rollover time (± standard deviation) was 9.5 seconds ± 4.8. Seventy-six percent of patients (75 of 98) achieved a needle-out patient-rollover time of 10 seconds or less. Unsuitability for the rapid needle-out patient-rollover time technique resulted in exclusion of 1.8% of patients. An increased number of pneumothoraces (25 [37%] vs 22 [23%]; P = .04) and an increased number of drainage catheter insertions were noted in group 1 compared with group 2 (10 [15%] versus four [4%], respectively; P = .029). At multiple regression analysis for group 1, lesion size and emphysema along the needle track were independent risk factors for pneumothorax (P = .032 and .021, respectively), and emphysema along the needle track was an independent predictor for insertion of a drainage catheter (P = .005). No independent predictor was identified for pneumothorax or insertion of a drainage catheter in group 2.Conclusion:Rapid needle-out patient-rollover time during percutaneous CT-guided transthoracic lung biopsy reduces the rate of overall pneumothorax and pneumothorax necessitating a drainage catheter. Use of this technique attenuates the influence of traditional risk factors for pneumothorax.© RSNA, 2011.
Ailbhe C O'Neill; Colin McCarthy; Carole A Ridge; Patrick Mitchell; Emer Hanrahan; Marcus Butler; Michael P Keane; Jonathan D Dodd
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-21
Journal Detail:
Title:  Radiology     Volume:  -     ISSN:  1527-1315     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Departments of Radiology, Respiratory Medicine, and Oncology, St Vincent's University Hospital, Dublin 4, Dublin, Ireland.
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