Enhancing safety in CT-guided lung biopsies: correlation of MinIP imaging with pneumothorax risk prediction
Abstract Objectives This study aimed to evaluate whether minimum-intensity projection (MinIP) images could predict complications in CT-guided lung biopsies. Methods We retrospectively analyzed 72 procedures from January 2019 to December 2023, categorizing patients by pneumothorax and the severity of...
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SpringerOpen
2025-01-01
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| Series: | Insights into Imaging |
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| Online Access: | https://doi.org/10.1186/s13244-024-01890-7 |
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| author | Michael P. Brönnimann Leonie Manser Bernhard Gebauer Timo A. Auer Dirk Schnapauff Federico Collettini Alexander Pöllinger Alois Komarek Miltiadis E. Krokidis Johannes T. Heverhagen |
| author_facet | Michael P. Brönnimann Leonie Manser Bernhard Gebauer Timo A. Auer Dirk Schnapauff Federico Collettini Alexander Pöllinger Alois Komarek Miltiadis E. Krokidis Johannes T. Heverhagen |
| author_sort | Michael P. Brönnimann |
| collection | DOAJ |
| description | Abstract Objectives This study aimed to evaluate whether minimum-intensity projection (MinIP) images could predict complications in CT-guided lung biopsies. Methods We retrospectively analyzed 72 procedures from January 2019 to December 2023, categorizing patients by pneumothorax and the severity of hemorrhage (grade 2 or higher). Radiodensity measurements were performed using lung window (LW) and MinIP (10-mm slab) images. Regions of interest (ROIs) were placed at sites of the lowest density along the biopsy pathway. Absolute values were recorded, categorized by a radiodensity level of −850 HU, and assessed using our bridged radiological observations with measurement-optimized model (BROM-OLB) model with validation from three additional ROIs. Emphysema was visually scored. Statistical analysis included univariate analysis (Fisher’s exact and Mann–Whitney U-tests) and binomial logistic regression to identify confounders. Results Lower radiodensity values in MinIP images in the access route, particularly with the BROM-OLB MinIP method, were significantly associated with a higher risk of pneumothorax (5/39, 13% vs 27/33, 82%, p < 0.01; Sensitivity 81.8% and Specificity 87.2%). Pneumothorax was more common with longer procedures (p < 0.05). Lower LW density values correlated with higher pulmonary hemorrhage rates (p < 0.01). Binomial logistic regression identified positive BROM-OLB MinIP results (OR 28.244, 95% CI: 7.675–103.9, p < 0.01) and lower LW density (OR 0.992, 95% CI: 0.985–0.999, p = 0.025) as independent risk factors. The optimal threshold values to predict pneumothorax were −868 HU in MinIP images and −769 HU in LW. Conclusion The assessment of MinIP images is superior, and in combination with relative quantitative measurement of radiodensity for access route planning, it can reduce the risk of pneumothorax in CT-guided lung biopsies. Critical relevance statement This article critically evaluates the risk factors for complications in CT-guided lung biopsies, highlighting the potential of MinIP images for predicting pneumothorax risk, thereby advancing clinical radiology practices to improve patient safety and reduce healthcare costs. Key Points This work investigates if MinIP images efficiently predict CT-guided lung biopsy complications. MinIP imaging identified higher pneumothorax risk post-CT lung biopsy with superior accuracy. Our method detects high-risk lung changes linked to pneumothorax without additional software. Graphical Abstract |
| format | Article |
| id | doaj-art-674a4229d3b34a8bba9e0e47101cce27 |
| institution | Kabale University |
| issn | 1869-4101 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Insights into Imaging |
| spelling | doaj-art-674a4229d3b34a8bba9e0e47101cce272025-01-19T12:26:11ZengSpringerOpenInsights into Imaging1869-41012025-01-0116111710.1186/s13244-024-01890-7Enhancing safety in CT-guided lung biopsies: correlation of MinIP imaging with pneumothorax risk predictionMichael P. Brönnimann0Leonie Manser1Bernhard Gebauer2Timo A. Auer3Dirk Schnapauff4Federico Collettini5Alexander Pöllinger6Alois Komarek7Miltiadis E. Krokidis8Johannes T. Heverhagen9Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of BernDepartment of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of BernDepartment of Radiology, Charité—Universitätsmedizin BerlinDepartment of Radiology, Charité—Universitätsmedizin BerlinDepartment of Radiology, Charité—Universitätsmedizin BerlinDepartment of Radiology, Charité—Universitätsmedizin BerlinDepartment of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of BernDepartment of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of BernDepartment of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of BernDepartment of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of BernAbstract Objectives This study aimed to evaluate whether minimum-intensity projection (MinIP) images could predict complications in CT-guided lung biopsies. Methods We retrospectively analyzed 72 procedures from January 2019 to December 2023, categorizing patients by pneumothorax and the severity of hemorrhage (grade 2 or higher). Radiodensity measurements were performed using lung window (LW) and MinIP (10-mm slab) images. Regions of interest (ROIs) were placed at sites of the lowest density along the biopsy pathway. Absolute values were recorded, categorized by a radiodensity level of −850 HU, and assessed using our bridged radiological observations with measurement-optimized model (BROM-OLB) model with validation from three additional ROIs. Emphysema was visually scored. Statistical analysis included univariate analysis (Fisher’s exact and Mann–Whitney U-tests) and binomial logistic regression to identify confounders. Results Lower radiodensity values in MinIP images in the access route, particularly with the BROM-OLB MinIP method, were significantly associated with a higher risk of pneumothorax (5/39, 13% vs 27/33, 82%, p < 0.01; Sensitivity 81.8% and Specificity 87.2%). Pneumothorax was more common with longer procedures (p < 0.05). Lower LW density values correlated with higher pulmonary hemorrhage rates (p < 0.01). Binomial logistic regression identified positive BROM-OLB MinIP results (OR 28.244, 95% CI: 7.675–103.9, p < 0.01) and lower LW density (OR 0.992, 95% CI: 0.985–0.999, p = 0.025) as independent risk factors. The optimal threshold values to predict pneumothorax were −868 HU in MinIP images and −769 HU in LW. Conclusion The assessment of MinIP images is superior, and in combination with relative quantitative measurement of radiodensity for access route planning, it can reduce the risk of pneumothorax in CT-guided lung biopsies. Critical relevance statement This article critically evaluates the risk factors for complications in CT-guided lung biopsies, highlighting the potential of MinIP images for predicting pneumothorax risk, thereby advancing clinical radiology practices to improve patient safety and reduce healthcare costs. Key Points This work investigates if MinIP images efficiently predict CT-guided lung biopsy complications. MinIP imaging identified higher pneumothorax risk post-CT lung biopsy with superior accuracy. Our method detects high-risk lung changes linked to pneumothorax without additional software. Graphical Abstracthttps://doi.org/10.1186/s13244-024-01890-7PneumothoraxHemorrhageBiopsyRisk factorsTomography |
| spellingShingle | Michael P. Brönnimann Leonie Manser Bernhard Gebauer Timo A. Auer Dirk Schnapauff Federico Collettini Alexander Pöllinger Alois Komarek Miltiadis E. Krokidis Johannes T. Heverhagen Enhancing safety in CT-guided lung biopsies: correlation of MinIP imaging with pneumothorax risk prediction Insights into Imaging Pneumothorax Hemorrhage Biopsy Risk factors Tomography |
| title | Enhancing safety in CT-guided lung biopsies: correlation of MinIP imaging with pneumothorax risk prediction |
| title_full | Enhancing safety in CT-guided lung biopsies: correlation of MinIP imaging with pneumothorax risk prediction |
| title_fullStr | Enhancing safety in CT-guided lung biopsies: correlation of MinIP imaging with pneumothorax risk prediction |
| title_full_unstemmed | Enhancing safety in CT-guided lung biopsies: correlation of MinIP imaging with pneumothorax risk prediction |
| title_short | Enhancing safety in CT-guided lung biopsies: correlation of MinIP imaging with pneumothorax risk prediction |
| title_sort | enhancing safety in ct guided lung biopsies correlation of minip imaging with pneumothorax risk prediction |
| topic | Pneumothorax Hemorrhage Biopsy Risk factors Tomography |
| url | https://doi.org/10.1186/s13244-024-01890-7 |
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