Letter to the Editor
CT-guided transthoracic lung biopsy: Predictive factors of pneumothorax
Biópsia pulmonar transtorácica guiada por TC: factores preditivos de pneumotórax
J.F. Cruz
, R. Rolo, L. Iglésias, J. Cunha
Corresponding author
Serviço de Pneumologia, Hospital de Braga, Braga, Portugal
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Cruz, R. Rolo, L. Iglésias, J. Cunha" "autores" => array:4 [ 0 => array:4 [ "nombre" => "J.F." "apellidos" => "Cruz" "email" => array:1 [ 0 => "joaoffcruz@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Rolo" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Iglésias" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Cunha" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Serviço de Pneumologia, Hospital de Braga, Braga, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Biópsia pulmonar transtorácica guiada por TC: factores preditivos de pneumotórax" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Computed tomography (CT) guided transthoracic lung biopsy (TTLB) is a well established method in the diagnosis of intra-thoracic lesions with good diagnostic yield.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Pneumothorax is the most frequent complication with an incidence varying between 8% and 64%.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The objective of this study was to evaluate potential risk factors associated with the occurrence of pneumothorax in CT-guided TTLB. We performed a retrospective study of patients undergoing CT-guided TTLB between 2007 and 2012 in Braga Hospital. Clinical data and radiologic images of patients were reviewed.</p><p id="par0015" class="elsevierStylePara elsevierViewall">A total of 269 TTLB were performed (201 fine needle aspiration biopsies and 68 core biopsies), in 209 patients with a mean age of 64.2 years, 75.8% male, 60% with smoking habits. Pneumothorax rate was 20.8%. Treatment of pneumothorax with chest drainage was necessary in 10/269 biopsies (3.7%). An initial univariate analysis identified the following risk factors: larger needle size (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.033), smaller size of the lesion (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.001) and absence of pleural contact (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001) – <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. A multiple logistic regression analysis has identified absence of pleural contact (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001; <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span> adjusted 0.107) and size of the lesion (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.030; <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span> adjusted 0.120) as significant independent risk factors for the occurrence of pneumothorax. Pneumothorax occurred in 41/111 (36.9%) biopsies in lesions without pleural contact vs 15/158 (9.5%) with pleural contact. Pneumothorax rate for lesions ≤<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>cm was 31% compared with 15.4% for lesions ><span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cm. Age, gender, smoking habits, presence of emphysema, needle size, presence of cavitation, contours, location and depth of lesion were not significantly associated with increased risk of pneumothorax.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">In our study, the absence of pleural contact was the most significant risk factor associated with the occurrence of post-TTLB pneumothorax. These data were corroborated by another retrospective study of Khan et al.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> in which lesions in the lung parenchyma had a higher pneumothorax rate than lesions located in the pleura or thoracic wall. Another significant risk factor identified was lesion size. There seems to be a gradual increase in the risk of pneumothorax to progressively smaller lesions. In a retrospective analysis of 660 biopsies, Yeow et al.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> showed that the risk of pneumothorax was about 11 times higher in lesions ≤2<span class="elsevierStyleHsp" style=""></span>cm than in lesions >4<span class="elsevierStyleHsp" style=""></span>cm.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In conclusion, this study supports the performance of CT-guided TTLB in the study of undetermined lung lesions as a safe method. Although the overall incidence of pneumothorax was 20.8%, the clinically significant pneumothorax rate requiring treatment with chest tube drainage was low (3.7%).</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Authorship</span><p id="par0030" class="elsevierStylePara elsevierViewall">João Filipe Cruz conceived this study, collected the data and carried out the statistical analysis. Rui Rolo collected the data, collaborated in the inception of the study and supervised all aspects of its implementation. Lourdes Iglésias and João Cunha contributed to the critical revision of the manuscript. All the authors contributed to the interpretation of the results and the proof reading of the manuscript.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Authorship" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflicts of interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Data presented as mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD or no. (%).</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col">Variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">All biopsies \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pneumothorax</th><th class="td" title="table-head " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">p</span> value \t\t\t\t\t\t\n \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Yes \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Biopsies, no.</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">269 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">213 (79.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">56 (20.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Age, years</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">64.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">64.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">62.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>15.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.752<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Gender male/female</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">204/65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">167/46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37/19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.055<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Smoking habits</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Smoker \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">80 (29.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">62 (29.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">18 (32.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="3" align="char" valign="middle">0.748<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ex-smoker \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">81 (30.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">63 (29.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">18 (32.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Non smoker \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">108 (40.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">88 (41.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20 (35.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Needle size</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FNAB (25<span class="elsevierStyleHsp" style=""></span>Ga) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">201 (74.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">153 (71.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">48 (85.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="2" align="char" valign="middle">0.033<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>CB (18<span class="elsevierStyleHsp" style=""></span>Ga) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">68 (25.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">60 (28.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 (14.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Lesion size, mm</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">48.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">51.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>28.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Lesion depth, mm</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">60.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>21.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">59.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>22.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">64.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>19.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.075<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Presence of emphysema</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">78 (29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">58 (27.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20 (35.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.213<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Lesion location</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Right upper lobe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">81 (30.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">61 (28.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20 (35.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="6" align="char" valign="middle">0.762<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Middle lobe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13 (4.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 (4.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 (7.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Right lower lobe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">58 (21.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">46 (21.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 (21.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Left upper lobe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">68 (25.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">55 (25.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13 (23.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Left lower lobe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">42 (15.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35 (16.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (12.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mediastinum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (2.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (3.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Lesion contours</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Regular \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">31 (12.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24 (11.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 (16.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="3" align="char" valign="middle">0.511<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Irregular/spiculated \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">216 (80.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">175 (82.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">41 (73.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Lobulated \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20 (7.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14 (6.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 (10.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Presence of cavitation</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24 (8.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17 (30.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (12.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.291<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Pleural contact</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">158 (58.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">143 (67.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15 (26.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="2" align="char" valign="middle"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">111 (41.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">70 (32.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">41 (73.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab884729.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Mann–Whitney <span class="elsevierStyleItalic">U</span> test.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Pearson <span class="elsevierStyleItalic">χ</span><span class="elsevierStyleSup">2</span> test.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Univariate analysis of demographic characteristics of patients and multiple variables of TTLB.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transthoracic needle biopsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.B. Katherine" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-0031-1273943" "Revista" => array:6 [ "tituloSerie" => "Semin Intervent Radiol" "fecha" => "2011" "volumen" => "28" "paginaInicial" => "87" "paginaFinal" => "97" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22379279" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "CT-guided cutting needle biopsy of lung lesions—safety and efficacy of an out-patient service" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.J. Charig" 1 => "A.J. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 14 | 9 | 23 |
| 2024 October | 63 | 32 | 95 |
| 2024 September | 60 | 31 | 91 |
| 2024 August | 71 | 51 | 122 |
| 2024 July | 56 | 49 | 105 |
| 2024 June | 38 | 19 | 57 |
| 2024 May | 42 | 45 | 87 |
| 2024 April | 40 | 26 | 66 |
| 2024 March | 33 | 29 | 62 |
| 2024 February | 32 | 24 | 56 |
| 2024 January | 28 | 19 | 47 |
| 2023 December | 21 | 24 | 45 |
| 2023 November | 27 | 33 | 60 |
| 2023 October | 35 | 47 | 82 |
| 2023 September | 31 | 29 | 60 |
| 2023 August | 29 | 16 | 45 |
| 2023 July | 22 | 26 | 48 |
| 2023 June | 23 | 13 | 36 |
| 2023 May | 30 | 29 | 59 |
| 2023 April | 21 | 17 | 38 |
| 2023 March | 57 | 20 | 77 |
| 2023 February | 36 | 17 | 53 |
| 2023 January | 22 | 17 | 39 |
| 2022 December | 55 | 21 | 76 |
| 2022 November | 57 | 25 | 82 |
| 2022 October | 60 | 33 | 93 |
| 2022 September | 50 | 22 | 72 |
| 2022 August | 103 | 48 | 151 |
| 2022 July | 63 | 37 | 100 |
| 2022 June | 30 | 25 | 55 |
| 2022 May | 37 | 46 | 83 |
| 2022 April | 38 | 27 | 65 |
| 2022 March | 30 | 37 | 67 |
| 2022 February | 52 | 33 | 85 |
| 2022 January | 41 | 24 | 65 |
| 2021 December | 24 | 35 | 59 |
| 2021 November | 31 | 28 | 59 |
| 2021 October | 38 | 39 | 77 |
| 2021 September | 27 | 31 | 58 |
| 2021 August | 19 | 18 | 37 |
| 2021 July | 31 | 27 | 58 |
| 2021 June | 43 | 30 | 73 |
| 2021 May | 37 | 24 | 61 |
| 2021 April | 69 | 54 | 123 |
| 2021 March | 56 | 13 | 69 |
| 2021 February | 51 | 13 | 64 |
| 2021 January | 36 | 15 | 51 |
| 2020 December | 25 | 9 | 34 |
| 2020 November | 37 | 15 | 52 |
| 2020 October | 30 | 17 | 47 |
| 2020 September | 50 | 21 | 71 |
| 2020 August | 65 | 22 | 87 |
| 2020 July | 71 | 22 | 93 |
| 2020 June | 68 | 16 | 84 |
| 2020 May | 55 | 20 | 75 |
| 2020 April | 54 | 7 | 61 |
| 2020 March | 43 | 10 | 53 |
| 2020 February | 66 | 13 | 79 |
| 2020 January | 69 | 19 | 88 |
| 2019 December | 52 | 19 | 71 |
| 2019 November | 76 | 7 | 83 |
| 2019 October | 64 | 21 | 85 |
| 2019 September | 55 | 22 | 77 |
| 2019 August | 90 | 19 | 109 |
| 2019 July | 115 | 16 | 131 |
| 2019 June | 98 | 14 | 112 |
| 2019 May | 102 | 21 | 123 |
| 2019 April | 96 | 24 | 120 |
| 2019 March | 101 | 14 | 115 |
| 2019 February | 95 | 9 | 104 |
| 2019 January | 107 | 26 | 133 |
| 2018 December | 60 | 11 | 71 |
| 2018 November | 38 | 2 | 40 |
| 2018 October | 50 | 5 | 55 |
| 2018 September | 36 | 4 | 40 |
| 2018 August | 45 | 28 | 73 |
| 2018 July | 60 | 18 | 78 |
| 2018 June | 49 | 16 | 65 |
| 2018 May | 71 | 15 | 86 |
| 2018 April | 94 | 24 | 118 |
| 2018 March | 99 | 16 | 115 |
| 2018 February | 38 | 14 | 52 |
| 2018 January | 64 | 11 | 75 |
| 2017 December | 80 | 17 | 97 |
| 2017 November | 59 | 8 | 67 |
| 2017 October | 29 | 14 | 43 |
| 2017 September | 40 | 12 | 52 |
| 2017 August | 20 | 16 | 36 |
| 2017 July | 27 | 18 | 45 |
| 2017 June | 25 | 20 | 45 |
| 2017 May | 40 | 21 | 61 |
| 2017 April | 20 | 8 | 28 |
| 2017 March | 19 | 13 | 32 |
| 2017 February | 18 | 3 | 21 |
| 2017 January | 15 | 3 | 18 |
| 2016 December | 10 | 13 | 23 |
| 2016 November | 14 | 11 | 25 |
| 2016 October | 9 | 6 | 15 |
| 2016 September | 6 | 5 | 11 |
| 2016 August | 5 | 4 | 9 |
| 2016 July | 7 | 9 | 16 |
| 2016 May | 0 | 9 | 9 |
| 2016 April | 24 | 1 | 25 |
| 2016 March | 27 | 17 | 44 |
| 2016 February | 38 | 26 | 64 |
| 2016 January | 30 | 16 | 46 |
| 2015 December | 50 | 16 | 66 |
| 2015 November | 24 | 7 | 31 |
| 2015 October | 33 | 3 | 36 |
| 2015 September | 46 | 10 | 56 |
| 2015 August | 36 | 7 | 43 |
| 2015 July | 24 | 8 | 32 |
| 2015 June | 28 | 11 | 39 |
| 2015 May | 67 | 3 | 70 |
| 2015 April | 26 | 18 | 44 |
| 2015 March | 29 | 3 | 32 |
| 2015 February | 28 | 7 | 35 |
| 2015 January | 29 | 8 | 37 |
| 2014 December | 38 | 22 | 60 |
| 2014 November | 34 | 8 | 42 |
| 2014 October | 40 | 16 | 56 |
| 2014 September | 25 | 23 | 48 |
| 2014 August | 41 | 20 | 61 |
| 2014 July | 44 | 25 | 69 |
| 2014 June | 49 | 37 | 86 |
| 2014 May | 65 | 47 | 112 |
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