• Serap Yucel, Asli Tanrivermis Sayit, Leman Tomak, and Cetin Celenk.
• From the Radiology Section, Mus State Hospital, Mus, Turkey.
• Ann Saudi Med. 2021 Mar 1; 41 (2): 78-85.

BackgroundAlthough transthoracic needle biopsy (TTNB) is an effective method for diagnosis of lung tumors, it has some complications. It is crucial to know the frequency and severity of the complications of TTNB and its risk factors in order to avoid them.ObjectivesEvaluate the complications and risk factors of computed tomography guided core needle lung biopsies (CT-CNLB).DesignProspective evaluation of complications.SettingSingle center in Turkey.Patients And MethodsFor CT-CNLBs performed between October 2017 and March 2018, the complications of biopsies were noted and classified as major and minor based on guidelines of the Society of Interventional Radiology.Main Outcome MeasuresThe complications and risk factors for complications were evaluated.Sample Size123 adult patients.ResultsThe most common complications were pulmonary hemorrhage (30.9%) and pneumothorax (22%). Increased overall pulmonary hemorrhage was observed with underlying emphysema (P=.022), non-peripheral location of the lesion (P<.001), increased needle pathway (P<.001), fissure penetration (P=.011), increased number of pleura penetrations (P=.024), prolonged needle time across pleura (P=.037), and decreased lesion size (P=.033). The pneumothorax rate increased with non-peripheral location of the lesion (P<.007), fissure penetration (P=.021), prolonged needle time across the pleura (P=.013), and decreased lesion size (P=.002). In the logistic regression analyses for he two most common complications, the only risk factor for both alveolar hemorrhage and pneumothorax was a non-peripheral location of the lesion (P<.001, OR=14.7, 95% CI=3.9-55.4 for alveolar hemorrhage) and (P=.001, OR=156.2, 95% CI =7.34-3324.7 for pneumothorax).ConclusionMost common complications of CT-CNLB were pneumothorax and pulmonary alveolar hemorrhage with a 5.7% major complication rate. Choosing the shortest possible trans-pulmonary needle pathway minimizes the risk of complications.LimitationsLimited number of patients, absence of rare complications as death, air embolism, and needle tract seeding.Conflict Of InterestNone.

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