Analysis of the risk factors associated with complications following CT-guided percutaneous core needle biopsy of small pulmonary nodules (≤1.5 cm): A single-center retrospective study

The aim of this study was to identify the risk factors associated with complications following computed tomography (CT)-guided percutaneous core needle biopsy (PCNB) of small pulmonary nodules (≤1.5 cm). From August 2019 to May 2023, the baseline and procedural technique characteristics of 107 consecutive patients who underwent PCNB for small pulmonary nodules (≤1.5 cm) in our hospital were analyzed retrospectively. The predictors of procedure-related pneumothorax and pulmonary hemorrhage were determined using univariate and multivariate logistic regression analyses. The incidences of pneumothorax and pulmonary hemorrhage were 43% (46/107) and 59.8% (64/107), respectively. Chronic obstructive pulmonary disease (COPD) (OR = 3.453, 95% CI = 1.431-11.532, P = .008) and a transpulmonary needle pathway > 3.0 cm (OR = 4.498, 95% CI = 1.269-9.398, P = .015) were independent risk factors for pneumothorax. A transpulmonary needle pathway > 3.0 cm (OR = 4.398, 95% CI = 1.350-14.324, P = .014) and a needle tract within the lesion > 1.0 cm (OR = 3.017, 95% CI = 1.303-6.986, P = .010) were independent risk factors for postprocedure pulmonary hemorrhage. CT-guided PCNB is a safe technique for small pulmonary nodules ≤ 1.5 cm, with acceptable complication rates. Identifying the predictors of pneumothorax and pulmonary hemorrhage postprocedure can help reduce the risk of such complications in future clinical practice.