Barzilai University Medical Center

100 Research Day 2020 Barzilai University Medical Center 72 THE YIELD OF IMMEDIATE POST LUNG BIOPSY CT IN PREDICTING IATROGENIC PNEUMOTHORAX: A SINGLE CENTER EXPERIENCE Rafael Y. Brzezinski 1,2 Ifat Vigiser 3 , Breslavsky A. 3 , Lilach Israeli 1 , Shani Shenhar-Tsarfaty 1 , and Amir Bar-Shai 3 1 Department of Internal Medicine “C”, “D” and “E”, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 2 Neufeld Cardiac Research Institute, Sackler Faculty of Medicine, Tel Aviv University, Israel; Tamman Cardiovascular Research Institute, Leviev Heart Center, Sheba Medical Center, Tel- Hashomer, Israel. 3 Division of Pulmonary Medicine, Barzilai University Medical Center and Faculty of Health Sciences, Ben-Gurion University, Ashkelon, Israel. Background The most prevalent complication of percutaneous lung biopsy is pneumothorax (PNX). A routine immediate post-procedure CT scan (ICT) to spot PNX is done in many centers. However, the diagnostic yield of this practice has not been studied broadly. We sought to evaluate whether an ICT could replace the routine follow-up CXR in detecting procedure related PNX. Methods We examined case-records of 453 patients who underwent lung biopsy at the Tel Aviv Medical Center . We analyzed findings from CXR performed 2-hours after biopsy and intermittent selected CT images at the site of biopsy acquired immediately after the procedure (ICT). Multivariate analysis was used to identify the risk factors for PNX, and we examined the concordance between ICT and CXR-2-hours post-procedure. Results A total of 87 patients (19%) were diagnosed with PNX on CXR-2-hours post-procedure. ICT detected 80.5% of diagnosed PNX (p<0.01). However, ICT demonstrated a negative predictive value of 94%, meaning 17 patients (6%) with a negative ICT did eventually develop PNX seen on CXR. Interestingly, bleeding surrounding the puncture area spotted on ICT negatively predicted the development of PNX (OR= 0.4 95% CI; 0.2-0.7). Conclusion We conclude that a CT scan performed immediately after percutaneous lung biopsy cannot replace the routine follow-up CXR in predicting iatrogenic PNX. Bleeding in the needle's tract may lower the risk for procedure-related PNX.