Factors influencing the total procedure time of CT-guided percutaneous core-needle biopsies of lung nodules: a retrospective analysis

PURPOSE This study aims to investigate the factors that influence total procedure time when performing computed tomography (CT)-guided percutaneous core-needle lung biopsies. METHODS This is a cross-sectional study of 673 patients, who underwent a CT-guided percutaneous coreneedle 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 linear regression and a multivariate stepwise linear 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 (estimated difference in time = 1.19), collecting additional core biopsies (estimated difference in time = 1.10), decubitus nodule side up (DNSU; estimated difference in time = 1.42), and supine positioning (estimated difference in time = 1.16) relative to decubitus nodule side down positioning, and increased nodule distance from the skin surface (estimated difference in time = 1.03). Increased nodule length (estimated difference in time = 0.93) was associated with reductions in procedure duration. Prolonged procedure time was associated with an increased rate of pneumothorax (odds ratio (OR) = 1.02; P <.0001) and decreased rate of pulmonary hemorrhage (OR = 0.97; P <.0001). CONCLUSION The 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.