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Review
. 2017 Jan;27(1):138-148.
doi: 10.1007/s00330-016-4357-8. Epub 2016 Apr 23.

Complication rates of CT-guided transthoracic lung biopsy: meta-analysis

W J Heerink  1   2 , G H de Bock  3   4 , G J de Jonge  5 , H J M Groen  3   6 , R Vliegenthart  3   5 , M Oudkerk  3
Affiliations
Review

Complication rates of CT-guided transthoracic lung biopsy: meta-analysis

W J Heerink et al. Eur Radiol. 2017 Jan.

Abstract

Objectives: To meta-analyze complication rate in computed tomography (CT)-guided transthoracic lung biopsy and associated risk factors.

Methods: Four databases were searched from 1/2000 to 8/2015 for studies reporting complications in CT-guided lung biopsy. Overall and major complication rates were pooled and compared between core biopsy and fine needle aspiration (FNA) using the random-effects model. Risk factors for complications in core biopsy and FNA were identified in meta-regression analysis.

Results: For core biopsy, 32 articles (8,133 procedures) were included and for FNA, 17 (4,620 procedures). Pooled overall complication rates for core biopsy and FNA were 38.8 % (95 % CI: 34.3-43.5 %) and 24.0 % (95 % CI: 18.2-30.8 %), respectively. Major complication rates were 5.7 % (95 % CI: 4.4-7.4 %) and 4.4 % (95 % CI: 2.7-7.0 %), respectively. Overall complication rate was higher for core biopsy compared to FNA (p < 0.001). For FNA, larger needle diameter was a risk factor for overall complications, and increased traversed lung parenchyma and smaller lesion size were risk factors for major complications. For core biopsy, no significant risk factors were identified.

Conclusions: In CT-guided lung biopsy, minor complications were common and occurred more often in core biopsy than FNA. Major complication rate was low. For FNA, smaller nodule diameter, larger needle diameter and increased traversed lung parenchyma were risk factors for complications.

Key points: • Minor complications are common in CT-guided lung biopsy • Major complication rate is low in CT-guided lung biopsy • CT-guided lung biopsy complications occur more often in core biopsy than FNA • Major complication rate is similar in core biopsy and FNA • Risk factors for FNA are larger needle diameter, smaller lesion size.

Keywords: Biopsy; Computed tomography, X-Ray; Lung neoplasms; Meta-analysis; Pneumothorax.

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Figures

Fig. 1
Fig. 1
PRISMA flow chart of article selection process
Fig. 2
Fig. 2
Funnel plot of major complications of CT-guided core biopsy
Fig. 3
Fig. 3
Funnel plot of major complications of CT-guided FNA
Fig. 4
Fig. 4
Scatter plot and regression line with 95 % confidence interval of mean needle diameter in relation to overall complication rate in FNA procedures. The size of the circles represents the relative weight of the study as assigned by the random effects model
See this image and copyright information in PMC

References

    1. Moyer VA. Screening for lung cancer: U.S. Preventive services task force recommendation statement. Ann Intern Med. 2014;160:330–8. - PubMed
    1. Kauczor H-U, Bonomo L, Gaga M, et al. ESR/ERS white paper on lung cancer screening. Eur Respir J. 2015;46:28–39. doi: 10.1183/09031936.00033015. - DOI - PMC - PubMed
    1. Cardella JF, Bakal CW, Bertino RE, et al. Quality improvement guidelines for image-guided percutaneous biopsy in adults: society of cardiovascular & interventional radiology standards of practice committee. J Vasc Interv Radiol. 1996;7:943–6. doi: 10.1016/S1051-0443(96)70875-8. - DOI - PubMed
    1. Manhire A, Charig M, Clelland C, et al. Guidelines for radiologically guided lung biopsy. Thorax. 2003;58:920–36. doi: 10.1136/thorax.58.11.920. - DOI - PMC - PubMed
    1. Beslic S, Zukic F, Milisic S. Percutaneous transthoracic CT guided biopsies of lung lesions; fine needle aspiration biopsy versus core biopsy. Radiol Oncol. 2012;46:19–22. doi: 10.2478/v10019-012-0004-4. - DOI - PMC - PubMed

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