A new score predicting intraprocedural risk in patients undergoing CT-guided percutaneous needle pulmonary biopsy (CATH-score)

Roberto Iezzi, Anna Rita Larici, Stefano Margaritora, Riccardo Manfredi, Andrea Contegiacomo, Alessandra Siciliani, Amato Infante, Pierluigi Granone, A. Contegiacomo, M. T. Congedo, A. Siciliani, A. Infante, G. Coppola, F. Carchesio, P. Granone

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVE: To develop a new score (CATH-score) for predicting intra-procedural risk in patients undergoing CT-guided percutaneous needle pulmonary biopsy. PATIENTS AND METHODS: 100 CT-guided lung biopsies performed with a 18 Gauge (G) needle (Pilot Group) were reviewed to analyse patient-, lesion- and procedure-related variables to identify risk factors for procedural complications (pneumothorax and parenchymal bleeding) and diagnosis failure. A scoring system for predicting complications and choosing the right needle (16 G, 18 G, 21 G) was developed using risk factors weighting and prospectively applied to 153 consecutive biopsies (CATH-score Group); complications and diagnostic rates obtained were compared with a group of patients (Control Group) that underwent lung biopsy; in this group of patients the choice of the calliper of the needle was based on the operator experience. RESULTS: lesion diameter (p=0.03), central location of lesion (p=0.02), centrilobular emphysema (p=0.04) and trans-pulmonary needle route (p=0.002) were associated with a higher complications rate in Pilot Group and were selected as risk factors to include in the CATH-score definition. Risk factors "cut-off" values were identified (Receiver Operating Characteristics curves) and risk-stratification groups were classified as follows: low (16 G, score 1), intermediate (18 G, score 2), and high procedural risk score (21 G, score 3). CATH-score usage limited complications rate despite a higher number of 16 G needle employed, with a diagnostic performance rising respect to Control Group. CONCLUSIONS: CATH-score seems to be a valuable tool for predicting the risk of complications and choosing the right needle, in order to increase diagnostic performance in patients undergoing TTNA.
Original languageEnglish
Pages (from-to)3554-3562
Number of pages9
JournalEuropean Review for Medical and Pharmacological Sciences
Volume21
Publication statusPublished - 2017

Keywords

  • LUNG BIOPSY

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