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Contralateral Dependent Position During Percutaneous CT-Guided Core Needle Biopsy for Small (≤ 20 mm) Lung Lesions Adjacent to the Pericardium: Effect on Procedures and Complications

  • Clinical Investigation
  • Non-Vascular Interventions
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Abstract

Purpose

To assess the effect of contralateral dependent position on procedures and complications of percutaneous computed tomography (CT)-guided core needle biopsy (PCT-CNB) for small (≤ 20 mm) lung lesions adjacent to the pericardium.

Materials and Methods

Retrospective view was performed to identify patients with small (≤ 20 mm) lung lesions located within 10 mm of the pericardium and who underwent PCT-CNB in the standard supine or prone position (n = 66) or in contralateral dependent position ( n = 35) between March 2010 and January 2020. In 35 patients, CT images in the contralateral dependent position were compared with images in the supine position to assess the mean distance of the lesion from the pericardium and the mean length of interface between these two positions. Complications including rates of pneumothorax, chest tube insertion, and pulmonary hemorrhage were assessed.

Results

In comparison with axial images in supine position, the pericardium were located farther from the lesion in the contralateral dependent position; the mean distance of lesions from the pericardium became farther (P < 0.001), and the mean length of interface with the pericardium became shorter (P = 0.008). There was no difference in the complication rates between supine or prone position and contralateral dependent position (pneumothorax, P = 0.098; pulmonary hemorrhage, P = 0.791).

Conclusion

Placing patients in contralateral dependent position may confer some advantages, including maximizing distance and minimizing length of interface of the lesion to the pericardium during PCT-CNB for small (≤ 20 mm) lung lesions adjacent to the pericardium.

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Acknowledgment

None.

Funding

This study was funded by National Key Research and Development Programe of China (No. 2016YFC0106203) and Programe of Shanghai Hospital Development Center (No. SHDC22017102).

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Author notes

  1. Chao Chen, Lichao Xu and Jia He contributed equally.

Authors and Affiliations

  1. Deparment of Interventional Radiology, Fudan University Shanghai Cancer Center, No. 270 Dongan Road, Xuhui, Shanghai, 200032, China

    Chao Chen, Lichao Xu, Ying Wang, Biao Wang, Wentao Li & Xinhong He

  2. Blood Purification Room, Queshan County People’s Hospital, Zhumadian, Henan Province, 463200, China

    Jia He

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Chen, C., Xu, L., He, J. et al. Contralateral Dependent Position During Percutaneous CT-Guided Core Needle Biopsy for Small (≤ 20 mm) Lung Lesions Adjacent to the Pericardium: Effect on Procedures and Complications. Cardiovasc Intervent Radiol 43, 1652–1660 (2020). https://doi.org/10.1007/s00270-020-02608-0

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