Percutaneous core needle biopsy of 566 peripheral lung lesions: analysis of factors associated with biopsy failure and postprocedural pneumothorax.

Objective: To evaluate the safety and efficacy of percutaneous transthoracic core needle biopsy (PCNB) for peripheral lung lesions and to identify factors associated with diagnostic failure and occurrence of significant pneumothorax.

Methods: Data from 566 PCNB procedures on lung lesions in contact with or adjacent to the visceral pleura at a distance less than 1 cm, performed at a single center between March 2019 and December 2021, were retrospectively reviewed. The electric medical records, including inpatient notes, radiology reports, and procedure reports were reviewed. Procedure details and lesion(s) characteristics were analyzed using univariate and multivariate logistic regression analyses to identify factors associated with diagnostic failure and postprocedural pneumothorax.

Results: The technical and diagnostic success rates were 100% and 90.1% (510/566), respectively. Postprocedural pneumothorax occurred in 19.4% (110/566) of patients. The severe adverse events that required prolongation of the hospital admission occurred in 3.4% (19/566). Univariate and multivariate analyses revealed that lesion diameter less than 10 mm (p<0.001) was associated with diagnostic failure, and the transfissural route (p = 0.042) and longer tract length (p = 0.018) were associated with the occurrence of postprocedural pneumothorax.

Conclusions: PCNB was an effective and safe diagnostic method for peripheral lung lesions, with a high diagnostic success rate and low incidence of postprocedural pneumothorax.