Factors influencing the total procedure time of CT-guided percutaneous core-needle biopsies of lung nodules: a retrospective analysis

Diagn Interv Radiol. 2022 Jul;28(4):337-343. doi: 10.5152/dir.2022.20731.


PURPOSE This study aims to investigate the factors that influence total procedure time when performing computed tomography (CT)-guided percutaneous core-needle lung biopsies. METHODS This is a cross-sectional study of 673 patients, who underwent a CT-guided percutaneous coreneedle biopsy at a tertiary care center from March 2014 to August 2016. Data on patient, nodule, and procedural factors and outcomes were collected retrospectively. Univariate linear regression and a multivariate stepwise linear regression were utilized for analysis. RESULTS Factors most strongly associated with prolonged procedure duration include 20-gauge needle use when compared with 18-gauge needle use (estimated difference in time=1.19), collecting additional core biopsies (estimated difference in time=1.10), decubitus nodule side up (DNSU; estimated difference in time=1.42), and supine positioning (estimated difference in time=1.16) relative to decubitus nodule side down positioning, and increased nodule distance from the skin surface (estimated difference in time=1.03). Increased nodule length (estimated difference in time=0.93) was associated with reductions in procedure duration. Prolonged procedure time was associated with an increased rate of pneumothorax (odds ratio (OR)=1.02; P < .0001) and decreased rate of pulmonary hemorrhage (OR=0.97; P < .0001). CONCLUSION The use of 20-gauge biopsy needle, collecting additional core biopsies, DNSU and supine positioning, smaller nodule size, and increasing nodule distance from the skin surface were associated with increased procedure time for CT-guided core needle biopsies of lung nodules. Prolonged procedure time is associated with a higher rate of pneumothorax and a lower rate of pulmonary hemorrhage.

MeSH terms

  • Biopsy, Large-Core Needle / methods
  • Cross-Sectional Studies
  • Hemorrhage
  • Humans
  • Image-Guided Biopsy / methods
  • Lung / diagnostic imaging
  • Lung / pathology
  • Lung Diseases* / pathology
  • Lung Neoplasms* / diagnostic imaging
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / surgery
  • Pneumothorax* / etiology
  • Pneumothorax* / pathology
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods