CT Guided Biopsy of Lung lesions – Prevalence of Pneumothorax and Variables affecting it.

Introduction: In oncology practice, pathological diagnosis ofthe disease is considered the standard for diagnosis. ComputedTomography is the optimal and most preferred image-guidingmodality for thoracic interventions for biopsy specimenprocurement. A well planned and executed CT guided biopsyprovides an accurate diagnosis and facilitates institution ofdefinitive treatment. Study aimed to find out prevalence ofpneumothorax in Computed Tomography guided biopsyof lung lesions and to find out the factors affecting risk ofpneumothorax in Computed Tomography guided biopsy oflung lesions.Material and methods: This observational study of CTguided lung lesion biopsy was performed from September2017 to September 2019 at a tertiary hospital. Proper preprocedure planning and all precautionary measures were takento reduce development of Pneumothorax.Results: A total of 50 patients were included in the studywhich showed prevalence of pneumothorax was found to bemore common in males, smokers, older age groups and inpatients with underlying emphysema. Risk of pneumothoraxwas also found to increase with multiple pleural puncturesand with increasing procedure time. Smaller sized and deeperseated lesions also had more occurrence of pneumothoraxlikely due to direct relation with increasing intrapulmonarybiopsy tract length. Superficial sub pleural lesions had lesseroccurrence of pneumothorax. Decubitus Positioning had least(0%) association with Pneumothorax as compared to supine(25%) and prone (18.1%).Conclusion: Percutaneous CT guided interventions like corebiopsy are relatively simple minimally invasive procedureswith good patient acceptance, low morbidity and almostnegligible mortality. They provide diagnosis of thoracic lesionsquickly and accurately if they are successful in procuringright tissue for histopathological analysis. Knowledge ofthese factors may augment pre-procedure planning. Referringdoctors be aware of these factors and should explain andcommunicate these risks to the patient and family before theprocedure.