European Radiology

, Volume 28, Issue 4, pp 1410–1419 | Cite as

Risk factors for haemoptysis after percutaneous transthoracic needle biopsies in 4,172 cases: Focusing on the effects of enlarged main pulmonary artery diameter

  • Eui Jin Hwang
  • Chang Min ParkEmail author
  • Soon Ho Yoon
  • Hyun-Ju Lim
  • Jin Mo Goo



To evaluate the risk factors for haemoptysis after cone-beam computed tomography (CBCT)-guided percutaneous transthoracic needle biopsy (PTNB), particularly on whether the enlargement of main pulmonary artery diameter (mPAD) is a risk factor for PTNB-related haemoptysis.


4,172 cases of CBCT-guided PTNBs in 3,840 patients were retrospectively included in this study. Various data including mPAD measured on preprocedural CT images were evaluated using logistic regression analyses to determine significant risk factors for both haemoptysis and severe haemoptysis, designated as when blood transfusion, vascular embolisation or cardiopulmonary resuscitation were required to manage patients with haemoptysis.


Haemoptysis occurred in 5.78 % (241/4172) of all PTNB procedures, while severe haemoptysis occurred in 0.18 % (7/4172). Female sex, history of antiplatelet or anticoagulative drugs, prolonged activated partial thromboplastin time, subsolid nodules, cavitary nodules and long pleura-to-target distance were revealed to be independent risk factors for haemoptysis, while mPAD enlargement (> 29.5 mm) was not. Regarding severe haemoptysis, however, mPAD enlargement was demonstrated to be an independent risk factor along with the presence of subsolid and cavitary target nodules.


mPAD enlargement was not a significant risk factor for PTNB-related haemoptysis; however, it was a significant risk factor for severe haemoptysis.

Key points

• mPAD enlargement was a significant risk factor for severe PTNB-related haemoptysis.

• mPAD can be useful in screening high-risk patients for severe haemoptysis.

• Subsolid or cavitary nodule was another significant risk factor for severe haemoptysis.


Cone-Beam computed tomography Lung nodule Image-guided biopsy Haemoptysis Pulmonary artery 



Activated partial thromboplastin time


Cone-beam computed tomography


International normalised ratio


Main pulmonary artery diameter


Odds ratio


Prothrombin time


Percutaneous transthoracic needle biopsy



The present study was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea (grant number: HC15C3390)

Compliance with ethical standards


The scientific guarantor of this publication is Chang Min Park, MD, PhD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Among our study population, 42.8 % (1,787 out of 4,172 patients) were reported in previous publications (Lee SM, Park CM, Lee KH, Bahn YE, Kim JI, Goo JM (2014) Radiology 271:291-300 and Kim JI, Park CM, Lee SM, Goo JM (2015) Eur Radiol 25:1845-1853). However, those previous studies dealt with different topics to the current paper. One of those studies (Lee SM et al) evaluated the diagnostic accuracy of CBCT-guided PTNBs and complication rates in general and the other paper (Kim JI et al) dealt with the usefulness of rapid needle-out-patient-rollover manoeuvre with respect to the reduction of the occurrence of pneumothorax and its drainage catheter placement.


• retrospective

• observational

• performed at one institution


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  1. 1.Department of RadiologySeoul National University College of MedicineSeoulKorea
  2. 2.Institute of Radiation MedicineSeoul National University Medical Research CentreSeoulKorea
  3. 3.Cancer Research InstituteSeoul National UniversitySeoulKorea

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