Percutaneous CT guided lung biopsy in patients with pulmonary hypertension: Assessment of complications

PurposeTo assess the complications of CT-guided percutaneous transthoracic needle aspiration and/or core biopsy (PTNAB) of lung nodules in patients with pulmonary arterial hypertension (PHTN).Method and materialsWe analyzed PTNAB of 74 lung lesions (mean size: 3.6 ± 2.1 cm) in 74 patients (M: F 38:36; age 68 ± 15 years) with documented PHTN on cardiac ultrasound. 39 patients with lung lesions (M: F 24:15; age 65 ± 14) who underwent PTNAB in the same period with right ventricle systolic pressure (RVSP) <35 mmHg were selected as controls. Pulmonary arterial pressures were estimated on cardiac ultrasounds by using the tricuspid regurgitation jet method. Two thoracic radiologists reviewed the medical records and PTNAB images on a PACS station and documented nodule size, location, distance traversed in lung, technical success and complications.ResultsFine needle aspirates were obtained in all and core biopsy in 23% (17/74) of the nodules. 61% (45/74) of the nodules were in the middle and 39% (29/74) were in the outer third of lung. PHTN was mild, moderate and severe in 84% (62/74), 13% (10/74) and 3% (2/74) of the patients. Biopsy was complicated by hemorrhage in 26% (19/74), moderate hemoptysis in 1.3% (1/74), pneumothorax in 17% (12/74), chest tube in 1.3% (1/74) and hemothorax in 1.3% (1/74) of the patients. The complications rate in control group was similar, hemorrhage in 33% (19/39) (p = 0.6), moderate hemoptysis in 5% (2/39) (p = 0.3), pneumothorax in 28% (11/39) (p = 0.2), chest tube in (0/39) (p = 0.3), and hemothorax in 3% (1/39) of the patients (p = 0.7).ConclusionPercutaneous needle biopsy of lung lesions in patients with mild to moderate PHTN can be performed without significant increase in complications.