Role of computed tomography performed 10 min after computed tomography-guided transthoracic lung biopsy in the management of complicated pneumothorax

BackgroundManagement strategies for small pneumothorax after computed tomography (CT)-guided lung biopsy may vary between institutions, and the approach to follow-up care can differ.PurposeTo evaluate the role of CT imaging performed 10 min after CT-guided lung biopsy in managing complicated small pneumothorax, particularly to assess its progression and guide subsequent treatment decisions.Material and MethodsA retrospective study was conducted on 86 cases of small pneumothorax identified immediately after CT-guided lung biopsy at our institution between January 2016 and December 2023. Small pneumothorax was defined as having insufficient space to insert a needle for aspiration. CT was performed 10 min after biopsy to assess pneumothorax progression, and cases were categorized into three groups: decreased, unchanged, or increased pneumothorax. Subsequent clinical courses and treatments were evaluated.ResultsAccording to CT performed 10 min after biopsy, pneumothorax decreased, unchanged, and increased in 37 (43.0%), 22 (25.6%), and 27 (31.4%) cases, respectively. Three cases (3.5%) with increased pneumothorax required manual aspiration at that time, which resolved within 3 days. In the 59 cases in which pneumothorax decreased or remained unchanged, 58 (98.3%) resolved spontaneously, while one case worsened after 4 days, requiring delayed aspiration.ConclusionCT performed 10 min following biopsy may be a valuable tool for predicting the course of small pneumothorax. In the absence of worsening, the likelihood of subsequent progression requiring treatment is minimal. Observation for 10 min and performing manual aspiration in cases with worsening pneumothorax may reduce the need for further treatment, contributing to improved patient management.