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E1442. Factors Influencing the Total Procedure Time of CT-Guided Percutaneous Core Needle Biopsies of Lung Nodules
Authors
  1. Tyler Sargent; Oakland University William Beaumont School of Medicine
  2. Nathan Kolderman; Beaumont Health System
  3. Girish Nair; Beaumont Health System
  4. Michelle Jankowski; Oakland University William Beaumont School of Medicine
  5. Sayf Al-Katib; Beaumont Health System
Objective:
This study aims to investigate the factors that influence total procedure time when performing CT-guided percutaneous core needle lung biopsies.

Materials and Methods:
Cross-sectional study of 673 patients, who underwent a CT-guided percutaneous core needle biopsy at a tertiary care center from March 2014 to August 2016. Data on patient, nodule, and procedural factors and outcomes were collected retrospectively. Univariate log-linear regression, logistic regression, and a multivariate stepwise regression were utilized for analysis.

Results:
Factors most strongly associated with prolonged procedure duration include 20-gauge needle use when compared with 18-gauge needle use (estimate=1.19; p<0.0001), collecting additional core biopsies (estimate=1.10; p<0.0001), decubitus nodule side up (DNSU; estimate=1.42; p<0.0001) and supine positioning (estimate=1.16; p<0.0001) relative to decubitus nodule side down (DNSD) positioning, and increased nodule distance from the skin surface (estimate=1.03; p<0.0001). Increased nodule length (estimate=0.94; p<0.0001) was associated with reductions in procedure duration. Prolonged procedure time was associated with an increased rate of pneumothorax (OR=1.02; p<0.0001) and decreased rate of pulmonary hemorrhage (OR=0.97; p<0.0001).

Conclusion:
Use of 20-gauge biopsy needle, collecting additional core biopsies, DNSU and supine positioning, smaller nodule size, and increasing nodule distance from the skin surface were associated with increased procedure time for CT-guided core needle biopsies of lung nodules. Prolonged procedure time is associated with a higher rate of pneumothorax and a lower rate of pulmonary hemorrhage.