Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 16:80:100750.
doi: 10.1016/j.clinsp.2025.100750. Online ahead of print.

Risk factors and nomogram prediction model for pneumothorax after CT-guided coaxial biopsy combined with microwave ablation in ground-glass nodules

Canxing Wu  1 , Yangtao Zhao  1 , Mengjun Chen  1 , Jun Ma  2
Affiliations

Risk factors and nomogram prediction model for pneumothorax after CT-guided coaxial biopsy combined with microwave ablation in ground-glass nodules

Canxing Wu et al. Clinics (Sao Paulo). .

Abstract

Objective: To identify risk factors and develop a validated nomogram for predicting pneumothorax after CT-guided coaxial biopsy with synchronous Microwave Ablation (MWA) in Ground-Glass Nodules (GGNs).

Methods: 383 GGN patients were divided into a training set (n = 268) and a validation set (n = 115) in a 7:3 ratio. Univariate and multivariate logistic regression were employed to identify risk factors, followed by the construction of a nomogram model. Receiver Operating Characteristic (ROC) curves and calibration plots were generated to evaluate model performance, with further validation in the independent cohort. Decision curve analysis was applied to assess clinical utility.

Results: Pneumothorax occurred in 72 cases (26.87 %) in the training set and 32 cases (27.83 %) in the validation set. Multivariate logistic regression revealed that BMI, lesion location, lesion depth, needle diameter, and number of punctures were independent risk factors for pneumothorax (all p < 0.05). Factor importance ranking was as follows: number of punctures > BMI > lesion depth > lesion location > needle diameter. The nomogram demonstrated robust calibration and predictive accuracy, with C-index values of 0.877 (training set) and 0.897 (validation set). The areas under the ROC curve (AUC) were 0.875 (95 % CI: 0.825-0.926) and 0.897 (95 % CI: 0.829-0.965), respectively. Sensitivity and specificity were 0.855/0.813 (training set) and 0.765/0.823 (validation set).

Conclusion: Key determinants of postprocedural pneumothorax in GGN patients were identified through logistic regression and nomogram modeling. The validated predictive model exhibited excellent discriminative ability and clinical applicability, providing a scientific basis for individualized risk assessment and intervention strategies.

Keywords: CT-guided percutaneous biopsy; Ground-glass nodule; Logistic regression; Microwave ablation; Pneumothorax.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare no conflicts of interest.

Figures

Fig 1
Fig. 1
Ranking of the importance of influencing factors.
Fig 2
Fig. 2
Nomogram model for pneumothorax after synchronous MWA treatment combined with CT-guided coaxial cannula puncture biopsy in patients with GGN. Note: X1, BMI; X2, Lesion location; X3, Lesion depth; X4, Puncture needle diameter; X5, Number of punctures.
Fig 3
Fig. 3
Calibration curves are presented (Curve A represents the calibration curve for the training set, while Curve B represents that for the validation set).
Fig 4
Fig. 4
ROC curves (A is the ROC curve of the training set, B is the ROC curve of the validation set).
Fig 5
Fig. 5
Decision curves (A represents the decision curve of the training set, B represents the decision curve of the validation set).
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. An W., Zhang H., Wang B., Zhong F., Wang S., Liao M. Comparison of CT-guided core needle biopsy in pulmonary ground-glass and solid nodules based on propensity score matching analysis. Technol Cancer Res Treat. 2022;21 - PMC - PubMed
    1. Han R., Wang L.F., Teng F., Lin J., Xian Y-T, Lu Y., et al. Presurgical computed tomography-guided localization of lung ground glass nodules: comparing hook-wire and indocyanine green. World J Surg Oncol. 2024;22(1):51. - PMC - PubMed
    1. Li C-D, Huang Z-G, Sun H-L, Wang L-T, Wang Y-L. CT-guided preoperative localization of ground glass nodule: comparison between the application of embolization microcoil and the locating needle designed for pulmonary nodules. Br J Radiol. 2021;94(1123) - PMC - PubMed
    1. Bao F., Yu F., Wang R., Chen C., Zhang Y., Lin B., et al. Electromagnetic bronchoscopy guided microwave ablation for early-stage lung cancer presenting as ground glass nodule. Transl Lung Cancer Res. 2021;10(9):3759–3770. - PMC - PubMed
    1. Yoshida R., Yoshizako T., Tanaka S., Ando S., Nakamura M., Kishimoto K., et al. CT-guided color marking of impalpable pulmonary nodules prior to video-assisted thoracoscopic surgery. Clin Imaging. 2021;74:84–88. - PubMed

LinkOut - more resources