Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 4/2018

01-04-2018 | Chest

Risk factors for haemoptysis after percutaneous transthoracic needle biopsies in 4,172 cases: Focusing on the effects of enlarged main pulmonary artery diameter

Authors: Eui Jin Hwang, Chang Min Park, Soon Ho Yoon, Hyun-Ju Lim, Jin Mo Goo

Published in: European Radiology | Issue 4/2018

Login to get access

Abstract

Objectives

To evaluate the risk factors for haemoptysis after cone-beam computed tomography (CBCT)-guided percutaneous transthoracic needle biopsy (PTNB), particularly on whether the enlargement of main pulmonary artery diameter (mPAD) is a risk factor for PTNB-related haemoptysis.

Methods

4,172 cases of CBCT-guided PTNBs in 3,840 patients were retrospectively included in this study. Various data including mPAD measured on preprocedural CT images were evaluated using logistic regression analyses to determine significant risk factors for both haemoptysis and severe haemoptysis, designated as when blood transfusion, vascular embolisation or cardiopulmonary resuscitation were required to manage patients with haemoptysis.

Results

Haemoptysis occurred in 5.78 % (241/4172) of all PTNB procedures, while severe haemoptysis occurred in 0.18 % (7/4172). Female sex, history of antiplatelet or anticoagulative drugs, prolonged activated partial thromboplastin time, subsolid nodules, cavitary nodules and long pleura-to-target distance were revealed to be independent risk factors for haemoptysis, while mPAD enlargement (> 29.5 mm) was not. Regarding severe haemoptysis, however, mPAD enlargement was demonstrated to be an independent risk factor along with the presence of subsolid and cavitary target nodules.

Conclusion

mPAD enlargement was not a significant risk factor for PTNB-related haemoptysis; however, it was a significant risk factor for severe haemoptysis.

Key points

• mPAD enlargement was a significant risk factor for severe PTNB-related haemoptysis.
• mPAD can be useful in screening high-risk patients for severe haemoptysis.
• Subsolid or cavitary nodule was another significant risk factor for severe haemoptysis.
Literature
1.
Travis WD, Brambilla E, Noguchi M et al (2011) International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society: international multidisciplinary classification of lung adenocarcinoma: executive summary. Proc Am Thorac Soc 8:381–385CrossRefPubMed
2.
Ohno Y, Hatabu H, Takenaka D et al (2003) CT-guided transthoracic needle aspiration biopsy of small (< or = 20 mm) solitary pulmonary nodules. AJR Am J Roentgenol 180:1665–1669CrossRefPubMed
3.
Heck SL, Blom P, Berstad A (2006) Accuracy and complications in computed tomography fluoroscopy-guided needle biopsies of lung masses. Eur Radiol 16:1387–1392CrossRefPubMed
4.
Choi JW, Park CM, Goo JM et al (2012) C-arm cone-beam CT-guided percutaneous transthoracic needle biopsy of small (</= 20 mm) lung nodules: diagnostic accuracy and complications in 161 patients. AJR Am J Roentgenol 199:W322–W330CrossRefPubMed
5.
Lee SM, Park CM, Lee KH, Bahn YE, Kim JI, Goo JM (2014) C-arm cone-beam CTguided percutaneous transthoracic needle biopsy of lung nodules: clinical experience in 1108 patients. Radiology 271:291–300CrossRefPubMed
6.
Hwang HS, Chung MJ, Lee JW, Shin SW, Lee KS (2010) C-arm cone-beam CT-guided percutaneous transthoracic lung biopsy: usefulness in evaluation of small pulmonary nodules. AJR Am J Roentgenol 195:W400–W407CrossRefPubMed
7.
Cheng YC, Tsai SH, Cheng Y, Chen JH, Chai JW, Chen CC (2015) Percutaneous Transthoracic Lung Biopsy: Comparison Between C-Arm Cone-Beam CT and Conventional CT Guidance. Tansl Oncol 8:258–264CrossRef
8.
Abi-Jaoudeh N, Fisher T, Jacobus J et al (2016) Prospective Randomized Trial for Image-Guided Biopsy Using Cone-Beam CT Navigation Compared with Conventional CT. J Vasc Interv Radiol 27:1342–1349CrossRefPubMed
9.
Rotolo N, Floridi C, Imperatori A et al (2016) Comparison of cone-beam CT-guided and CT fluoroscopy-guided transthoracic needle biopsy of lung nodules. Eur Radiol. 26:381–389CrossRefPubMed
10.
Westcott JL, Rao N, Colley DP (1997) Transthoracic needle biopsy of small pulmonary nodules. Radiology. 202:97–103CrossRefPubMed
11.
Sinner WN (1976) Complications of percutaneous transthoracic needle aspiration biopsy. Acta Radiologica Diagn (Stockh) 17:813–828CrossRef
12.
Tomiyama N, Yasuhara Y, Nakajima Y et al (2006) CT-guided needle biopsy of lung lesions: a survey of severe complication based on 9783 biopsies in Japan. Eur J Radiol. 59:60–64CrossRefPubMed
13.
Khouri NF, Stitik FP, Erozan YS et al (1985) Transthoracic needle aspiration biopsy of benign and malignant lung lesions. AJR Am J Roentgenol 144:281–288CrossRefPubMed
14.
15.
Perlmutt LM, Johnston WW, Dunnick NR (1989) Percutaneous transthoracic needle aspiration: a review. AJR Am J Roentgenol 152:451–455CrossRefPubMed
16.
Tai R, Dunne RM, Trotman-Dickenson B et al (2016) Frequency and Severity of Pulmonary Hemorrhage in Patients Undergoing Percutaneous CT-guided Transthoracic Lung Biopsy: Single-Institution Experience of 1175 Cases. Radiology 279:287–296CrossRefPubMed
17.
Kim JI, Park CM, Lee SM, Goo JM (2015) Rapid needle-out patient-rollover approach after cone beam CT-guided lung biopsy: effect on pneumothorax rate in 1,191 consecutive patients. Eur Radiol 25:1845–1853CrossRefPubMed
18.
Yeow KM, Su IH, Pan KT et al (2004) Risk factors of pneumothorax and bleeding: multivariate analysis of 660 CT-guided coaxial cutting needle lung biopsies. Chest 126:748–754CrossRefPubMed
19.
Song YS, Park CM, Park KW et al (2013) Does antiplatelet therapy increase the risk of hemoptysis during percutaneous transthoracic needle biopsy of a pulmonary lesion? AJR Am J Roentgenol 200:1014–1019CrossRefPubMed
20.
Ibrahim WH (2008) Massive haemoptysis: the definition should be revised. Eur Respir J 32:1131–1132CrossRefPubMed
21.
Yeow KM, See LC, Lui KW et al (2001) Risk factors for pneumothorax and bleeding after CT-guided percutaneous coaxial cutting needle biopsy of lung lesions. J Vasc Interv Radiol 12:1305–1312CrossRefPubMed
22.
Digumarthy SR, Kovacina B, Otrakji A, Lanuti M, Shepard JA, Sharma A (2016) Percutaneous CT guided lung biopsy in patients with pulmonary hypertension: Assessment of complications. Eur J Radiol 85:466–471CrossRefPubMed
23.
Corson N, Armato SG 3rd, Labby ZE, Straus C, Starkey A, Gomberg-Maitland M (2014) CT-based pulmonary artery measurements for the assessment of pulmonary hypertension. Acad Rad 21:523–530CrossRef
24.
Mahammedi A, Oshmyansky A, Hassoun PM, Thiemann DR, Siegelman SS (2013) Pulmonary artery measurements in pulmonary hypertension: the role of computed tomography. J Thorac Imaging 28:96–103CrossRefPubMed
25.
McCall RK, Ravenel JG, Nietert PJ, Granath A, Silver RM (2014) Relationship of main pulmonary artery diameter to pulmonary arterial pressure in scleroderma patients with and without interstitial fibrosis. J Comput Assist Tomogr 38:163–168CrossRefPubMedPubMedCentral
26.
Shen Y, Wan C, Tian P et al (2014) CT-base pulmonary artery measurement in the detection of pulmonary hypertension: a meta-analysis and systematic review. Medicine (Baltimore) 93:e256CrossRef
27.
Tan RT, Kuzo R, Goodman LR, Siegel R, Haasler GB, Presberg KW (1998) Utility of CT scan evaluation for predicting pulmonary hypertension in patients with parenchymal lung disease. Medical College of Wisconsin Lung Transplant Group. Chest 113:1250–1256
28.
Atwell TD, Smith RL, Hesley GK et al (2010) Incidence of bleeding after 15,181 percutaneous biopsies and the role of aspirin. AJR Am J Roentgenol 194:784–789CrossRefPubMed
29.
Corey R, Hla KM (1987) Major and massive hemoptysis: reassessment of conservative management. Am J Med Sci 294:301–309CrossRefPubMed
30.
Hirshberg B, Biran I, Glazer M, Kramer MR (1997) Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital. Chest 112:440–444CrossRefPubMed
31.
Knott-Craig CJ, Oostuizen JG, Rossouw G, Joubert JR, Barnard PM (1993) Management and prognosis of massive hemoptysis. Recent experience with 120 patients. J Thorac Cardiovasc Surg 105:394–397PubMed
32.
Yildirim E, Kirbas I, Harman A et al (2009) CT-guided cutting needle lung biopsy using modified coaxial technique: factors effecting risk of complications. Eur J Radiol 70:57–60CrossRefPubMed
Metadata
Title
Risk factors for haemoptysis after percutaneous transthoracic needle biopsies in 4,172 cases: Focusing on the effects of enlarged main pulmonary artery diameter
Authors
Eui Jin Hwang
Chang Min Park
Soon Ho Yoon
Hyun-Ju Lim
Jin Mo Goo
Publication date
01-04-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 4/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5101-8

Other articles of this Issue 4/2018

European Radiology 4/2018 Go to the issue

Gastrointestinal

CT texture features of liver parenchyma for predicting development of metastatic disease and overall survival in patients with colorectal cancer

Magnetic Resonance

Identification of intraplaque haemorrhage in carotid artery by simultaneous non-contrast angiography and intraPlaque haemorrhage (SNAP) imaging: a magnetic resonance vessel wall imaging study

Interventional

Intraprocedural 3D perfusion measurement during chemoembolisation with doxorubicin-eluting beads in liver metastases of malignant melanoma

Computed Tomography

Dual-layer DECT for multiphasic hepatic CT with 50 percent iodine load: a matched-pair comparison with a 120 kVp protocol

Paediatric

Assessment of micro-dose biplanar radiography in lower limb measurements in children

Health Economy

Radiologist involvement is associated with reduced use of MRI in the acute period of low back pain in a non-elderly population