Open Bronchus Sign on CT: A Risk Factor for Hemoptysis after Percutaneous Transthoracic Biopsy.
10.3348/kjr.2018.19.5.880
- Author:
Hyungjin KIM
1
;
Chang Min PARK
;
Soon Ho YOON
;
Eui Jin HWANG
;
Jong Hyuk LEE
;
Su Yeon AHN
;
Jin Mo GOO
Author Information
1. Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 03080, Korea. cmpark.morphius@gmail.com
- Publication Type:Original Article
- Keywords:
Lung neoplasms;
Image-guided biopsy;
Cone-beam computed tomography;
Hemoptysis;
Risk factors;
Open bronchus
- MeSH:
Biopsy*;
Biopsy, Needle;
Bronchi*;
Cone-Beam Computed Tomography;
Female;
Hematologic Tests;
Hemoptysis*;
Humans;
Image-Guided Biopsy;
Logistic Models;
Lung Neoplasms;
Male;
Needles;
Odds Ratio;
Retrospective Studies;
Risk Factors*
- From:Korean Journal of Radiology
2018;19(5):880-887
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: We hypothesized that open bronchi within target pulmonary lesions are associated with percutaneous transthoracic needle biopsy (PTNB)-related hemoptysis. We sought to analyze and compare patient characteristics and target features as well as biopsy-related factors between patients with and without PTNB-related hemoptysis. MATERIALS AND METHODS: We retrospectively analyzed 1484 patients (870 males and 614 females; median age, 66 years) who had undergone 1569 cone-beam CT (CBCT)-guided PTNBs. Patient characteristics (sex, age, and pathologic diagnosis), nodule features (nodule type, size, location, and presence of an open bronchus in target nodules), and biopsy-related factors (biopsy needle size, pleura-to-target distance, blood test results, open bronchus unavoidability [OBU] index, etc.) were investigated. OBU index, which was assessed using the pre-procedural CBCT, was a subjective scoring system for the probability of needle penetration into the open bronchus. Univariate analysis and subsequent multivariate logistic regression analysis were conducted to reveal the independent risk factors for PTNB-related hemoptysis. For a subgroup of nodules with open bronchi, a trend analysis between the occurrence of hemoptysis and the OBU index was performed. RESULTS: The independent risk factors for hemoptysis were sex (female; odds ratio [OR], 1.918; p < 0.001), nodule size (OR, 0.837; p < 0.001), open bronchus (OR, 2.101; p < 0.001), and pleura-to-target distance (OR, 1.135; p = 0.003). For the target nodules with open bronchi, a significant trend between hemoptysis and OBU index (p < 0.001) was observed. CONCLUSION: An open bronchus in a biopsy target is an independent predictor of hemoptysis, and careful imaging review may potentially reduce PTNB-related hemoptysis.
