Comparison of Outcome of CT Guided Lung Biopsy Using a 17-Gauge vs. 19-Gauge Biopsy Gun System

Wednesday, March 8, 2023

3:36 PM – 3:45 PM

Location: Phoenix Convention Center, 221AB

Presenting Author(s)

AP

Anmol Patel, MS-4

Medical Student
University of Miami Miller School of Medicine

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

Konrad Kozlowski, BA

Medical Student
University of Miami
Kenneth Richardson, MS-4

University of Miami Medical Student
University of Miami
Hamed Jalaeian, MD, MSc, RPVI (he/him/his)

Assistant Professor Clinical Interventional Radiology
University of Miami Health System
SV

Shree Venkat, MD

Attending
University of Miami

Disclosure(s):

Anmol Patel, MS-4: No financial relationships to disclose

Kenneth Richardson, MS-4: No financial relationships to disclose

Hamed Jalaeian, MD, MSc, RPVI: No financial relationships to disclose

Purpose: Core biopsy is used to diagnose and classify suspicious lung nodules. It is thought a larger bore biopsy needle yields a better sample but may increase risk of pneumothorax. This study compares outcomes of CT-guided lung biopsy using a 17-gauge vs. 19-gauge biopsy gun system.

Materials and Methods: 192 patients who underwent CT guided lung biopsy from 2013-2021 were evaluated in a retrospective study. Mean age 64.1 ±12.4 years, 47.7% smokers, 18.2% had emphysema, and mean nodule size 2.4(±1.4) cm. Patients were divided in two groups: Group A (20-gauge needle, 19-gauge introducer) n=134 (69.8%) and Group B 18-gauge needle, 17-gauge introducer) n=58 (30.2%). All biopsies obtained with Temno™ coaxial biopsy gun system (Merit Medical Systems, Inc., South Jordan, UT). Pneumothorax was identified by CT peri-op or chest X-ray 1-2 hours later. A two-tailed p-value < 0.05 was considered statistically significant.

Results: Overall pneumothorax rate was 42% with 10.9% requiring chest tube insertion and 11.9% requiring admission. Group A and Group B had similar characteristics (Table 1). Rate of pneumothorax, chest tube insertion and admission were not significantly different between groups. In a logistic regression model, length of lung parenchyma (OR = 1.31; 95% CI (1.13-1.53), ß=0.27, S.E.=0.07, (p< 0.001) and BMI (OR= 0.94; 95% CI (0.89-0.99), ß=-0.058, S.E.=0.028, (p=0.04) were predictive of pneumothorax while gauge of biopsy gun system was not.

Conclusion: Findings suggest similar pneumothorax and chest tube insertion rates with small vs large bore biopsy gun systems. Length of lung parenchyma traversed appears to be a risk factor for post-biopsy pneumothorax while BMI appears to be protective. Prospective studies with larger sample size are required to further evaluate outcomes of CT guided lung biopsy.