Evidence map›Paper›PMID 40232655›Full record

ArticleLa Radiologia medica2025

The role of gravitational effects and pre-puncture techniques in reducing pneumothorax during CT-guided lung biopsies.

Michael P Brönnimann, Maria C Barroso, Leonie Manser, Bernhard Gebauer, Timo A Auer, Federico Collettini, Patrick Dorn, Adrian T Huber, Johannes T Heverhagen, Martin H Maurer

Abstract read
In one paragraph

Article in La Radiologia medica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Michael P BrönnimannDepartment of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010, Bern, Switzerland.ORCID http://orcid.org/0000-0003-0552-4850
Maria C BarrosoDepartment of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010, Bern, Switzerland.
Leonie ManserDepartment of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010, Bern, Switzerland.
Bernhard GebauerDepartment of Radiology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Timo A AuerDepartment of Radiology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Federico CollettiniDepartment of Radiology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Patrick DornDepartment of Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 4, 3010, Bern, Switzerland.
Adrian T HuberDepartment of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010, Bern, Switzerland.
Johannes T HeverhagenDepartment of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010, Bern, Switzerland.
Martin H MaurerDepartment of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010, Bern, Switzerland. maurer.martin@klinikum-oldenburg.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe study aimed to evaluate whether the relative height (RH) of the entry point (EP) during CT-guided lung biopsies, adjusted for patient positioning, can predict the risk of pneumothorax during the intervention, leveraging the gravitational effects on pleural pressure. MATERIALS AND

methodsWe retrospectively analyzed 128 percutaneous CT-guided lung biopsies performed at a single center between January 2018 and December 2023. Patients were grouped based on pneumothorax occurrence. Various measurement methods indirectly assessed the influence of gravitational force on pleural pressure, focusing on the RH at the EP with prone positioning adjustments (PP). Other confounding factors like patient demographics, lesion characteristics, pre-puncture fluid administration and other procedural details were assessed. Test performance metrics were compared using Chi-Square, Fisher's exact, and Mann-Whitney U tests. Univariate and binomial logistic regression assessed the influence of different parameters on pneumothorax occurrence.

resultsAll measurements of lower RH at EP and pre-puncture fluid administration were significantly associated with a reduced incidence of peri-interventional pneumothorax (p < 0.01). The RH at EP adjusted for the prone position demonstrated the best predictive performance (AUC = 0.844). After adjusting for various confounding factors, both lower RH at EP adjusted for the prone position (OR 110.114, p < 0.001) and pleural fluid administration (OR 0.011, p = 0.011) remained independently associated with a lower risk of pneumothorax.

conclusionStrategic use of gravity by selecting the lowest possible entry point, ideally positioning the patient laterally, combined with pre-puncture pleural fluid administration, could be the key to reducing pneumothorax in CT-guided lung biopsies.

Indexed as

GravitationImage-Guided BiopsyLungPatient PositioningPneumothoraxRadiography, InterventionalTomography, X-Ray ComputedAdultAgedFemaleHumansMaleMiddle AgedProne PositionPuncturesRetrospective StudiesBiopsyImage-guided biopsyLungPatient positioningPneumothoraxPostoperative complications tomography

Identifiers

PMID40232655
PMCPMC12263723

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.