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)

Anmol Patel, MS-3

Medical Student
University of Miami Miller School of Medicine

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

KK

Konrad Kozlowski, MS2

Medical Student
University of Miami Miller School of Medicine
Kenneth Richardson, MS-3

University of Miami Medical Student
University of Miami
Hamed Jalaeian, MD

Assistant Professor Clinical Interventional Radiology
University of Miami Health System
SV

Shree Venkat, MD

Associate Professor
University of Miami

Disclosure(s):

Anmol Patel, MS-3: No financial relationships to disclose

Kenneth Richardson, MS-3: No financial relationships to disclose

Hamed Jalaeian, MD: 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.