Title : Safety and efficacy of ultrasound guided percutaneous transthoracic needle biopsy: A retrospective analysis of 3043 consecutive patients
Abstract:
Objective: This study aimed to evaluate the procedural safety and diagnostic efficacy of ultrasound-guided percutaneous transthoracic needle biopsy (US-PTNB), and to identify modifiable risk factors for associated complications.
Materials and Methods: We retrospectively analyzed 3,043 consecutive US-PTNB procedures performed between July 2019 and September 2021. The pathological diagnostic yield and postprocedural complication rates were documented and analyzed for all 3,043 patients. Demographic variables, pulmonary lesion characteristics, and biopsy-related technical variables were investigated to identify potential risk factors associated with complications.
Results: The overall diagnostic accuracy of US-PTNB was 94.08% (sensitivity: 93.21%; specificity: 95.48%; positive predictive value: 97.05%; negative predictive value: 89.81%). The overall complication rate was 4.83%. Independent risk factors for increased overall complications included: Benign (OR=2.292, 95% CI [1.598, 3.287], P<0.001), lower lobe (OR=2.347, 95% CI [1.616, 3.410], P<0.001), lesion diameter≤3cm(OR=1.993, 95% CI [1.387, 2.864], P<0.001), procedure duration>15 minutes(OR=3.069, 95% CI [2.134, 4.414], P<0.001), and inexperienced operators(OR=2.227, 95% CI [1.547, 3.206], P<0.001). Independent risk factors for hemoptysis included: Benign (OR=2.479, 95% CI [1.582, 3.884], P<0.001), lower lobe(OR=1.596, 95% CI [1.022, 2.491], P=0.040), procedure duration>15 minutes(OR=3.237, 95% CI [2.035, 5.149], P<0.001), and inexperienced operators(OR=6.429, 95% CI [3.536,11.690], P<0.001). Independent risk factors for pneumothorax included: Benign(OR=1.998, 95% CI [1.009, 3.958], P=0.047), lower lobe(OR=9.421, 95% CI [2.882, 30.790], P<0.001) and lesion diameter≤3cm(OR=9.147, 95% CI [4.285, 19.522], P<0.001).
Conclusion: US-PTNB demonstrates high diagnostic accuracy and a low complication rate. Benign, lower lobe, lesion diameter≤3cm, procedure duration>15 minutes and inexperienced operators were identified as independent risk factors for overall complications. Preprocedural assessment of these risk factors may help reduce the incidence of complications.
Keywords: ultrasound-guided percutaneous transthoracic needle biopsy (US-PTNB); complications; potential risk factor
