W Bowman Andrew, Li Zhuo
Department of Radiology, Mayo Clinic, Jacksonville, FL, USA.
Division of Clinical Trials and Biostatistics, Mayo Clinic, Jacksonville, FL, USA.
Abdom Radiol (NY). 2025 May;50(5):2286-2293. doi: 10.1007/s00261-024-04648-3. Epub 2024 Oct 28.
Percutaneous lung biopsies are a common radiologic procedure, although they are not without risk. As imaging techniques continue to increase in sophistication, referring providers may request lung biopsies on smaller and smaller targets. Our purpose is to better understand when we should expect lung biopsies to yield diagnostic results of lung nodules of varying sizes and how size impacts the complication rate of the procedure.
We retrospectively reviewed all outpatient lung biopsies performed at our institution between January 1, 2019, and June 30, 2020. For all procedures, target nodule size, location, diagnostic performance, and complication rates were recorded.
We found that diagnostic yield increased with increasing nodule size, with ROC analysis indicating that the best threshold size to predict a diagnostic sample is 1.4 cm. Pneumothorax rate significantly increased with decreasing target size, but there was no significant association between target size and the need for either chest tube placement or hospital admission.
The smaller a lung nodule is, the harder it is to obtain a diagnostic sample, and the more likely it is to develop a post-biopsy pneumothorax. However, smaller target size is not associated with an increased risk of chest tube placement or hospital admission.
经皮肺活检是一种常见的放射学检查方法，尽管并非没有风险。随着成像技术日益复杂，转诊医生可能会要求对越来越小的目标进行肺活检。我们的目的是更好地了解何时预期肺活检能得出不同大小肺结节的诊断结果，以及大小如何影响该检查的并发症发生率。
我们回顾性分析了2019年1月1日至2020年6月30日在我院进行的所有门诊肺活检。记录所有检查的目标结节大小、位置、诊断性能和并发症发生率。
我们发现诊断率随结节大小增加而提高，ROC分析表明预测诊断性样本的最佳阈值大小为1.4厘米。气胸发生率随目标大小减小而显著增加，但目标大小与放置胸管或住院需求之间无显著关联。
肺结节越小，获取诊断性样本越困难，活检后发生气胸的可能性越大。然而，较小的目标大小与放置胸管或住院风险增加无关。
