Use of spirometry to predict risk of pneumothorax in CT-guided needle biopsy of the lung

Objective: Our goal was to assess the usefulness of spirometry to estimate the risk of pneumothorax in patients undergoing percutaneous needle biopsy with CT guidance for solitary pulmonary nodule (SPN). Materials and Methods: We studied the results of 51 consecutive percutaneous needle biopsies with CT guidance for SPN obtained between 1988 and 1990. Forty-five men and six women, aged 65 +/- 11 (36-86) years, were included in the study. All biopsies were performed under CT guidance, with 90 mm 25G needles (0.5 mm thickness) fitted into luer-type syringes. The number of needle pass attempts never exceeded three. A spirometry before biopsy was performed in all patients. Results: Pneumothorax occurred in only 10 cases (19%). The patients with pneumothorax showed lower lesion size, forced vital capacity (FVC), forced expiratory volume (FEV(1)), and FEV(1)/FVC ratio. The contribution of these factors to pneumothorax was analyzed by a logistic regression model. The FEV(1) was most strongly associated with the incidence of pneumothorax. We developed an equation for predicting the risk of this complication. Conclusion: We conclude that decreasing FEV(1) is associated with a higher pneumothorax rate.