Nonlinear association between lung needle path CT attenuation values and postprocedural immediate pneumothorax following computed tomography-guided lung biopsy: a retrospective cohort study

Shao-Quan Zhou; Fang Luo; Xiong Ran; Jian Yang; Fu-Rong Lv; Kang Li

doi:10.1186/s12890-024-03343-9

Nonlinear association between lung needle path CT attenuation values and postprocedural immediate pneumothorax following computed tomography-guided lung biopsy: a retrospective cohort study

BMC Pulm Med. 2024 Nov 14;24(1):567. doi: 10.1186/s12890-024-03343-9.

Authors

Shao-Quan Zhou^#¹, Fang Luo^#², Xiong Ran¹, Jian Yang¹, Fu-Rong Lv³, Kang Li⁴

Affiliations

¹ Department of Radiology, Chongqing General Hospital, Yubei District, Chongqing, 401147, China.
² Department of Gastroenterology, The Chongqing Traditional Chinese Medicine Hospital, Chongqing Academy of Traditional Chinese Medicine, Chongqing, 400021, China.
³ Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China. [email protected].
⁴ Department of Radiology, Chongqing General Hospital, Yubei District, Chongqing, 401147, China. [email protected].

^# Contributed equally.

PMID: 39543604
DOI: 10.1186/s12890-024-03343-9

Abstract

Background: Pneumothorax is a potential complication following computed tomography-guided lung biopsy (CT-LB). However, the relationship between the lung needle path CT attenuation values and risk of post-procedural immediate pneumothorax remains unclear. The study aims to investigate this relationship.

Methods: The present single-center retrospective cohort study analyzed the data obtained from 453 patients who underwent CT-LB from 2019 to 2022. The relationship between the lung needle path CT attenuation values and post-procedural immediate pneumothorax was assessed using restricted cubic splines, which were adjusted for potential confounders, and validated using linear and nonlinear binomial logistic models.

Results: A total of 453 patients (mean age: 60.2 ± 12.0 years old, 217 male patients) were evaluated. The incidence of post-procedural immediate pneumothorax was 41.06% (186/453). The median needle path CT attenuation was - 831 Hounsfield units (Hu). The linear models indicated an unstable association between lung needle path CT attenuation and post-procedural immediate pneumothorax (odds ratio: 0.99, 95% confidence interval: 0.99-1.00). The nonlinear analysis identified an inflection point at a CT attenuation value of -805 Hu. A stronger negative link was identified for needle path CT attenuation values below - 805 Hu (odds ratio: 0.99, 95% confidence interval: 0.98-0.99) between the needle path CT attenuation value and pneumothorax, while no statistically significant association was identified between these when the CT attenuation value was above - 805 Hu.

Conclusion: There is a nonlinear association between the lung needle path CT attenuation values and risk of post-procedural immediate pneumothorax. For CT attenuation values below - 805 Hu, increasing the needle path CT attenuation values might reduce the risk of pneumothorax.

Keywords: Attenuation values; Computed tomography; Inflection point; Interventional radiology; Lung biopsy; Pneumothorax.