Adding a simple post-procedure maneuver to an existing technique may reduce the risk of pneumothorax after CT-guided lung biopsy, according to a retrospective single-center study published in BMC Pulmonary Medicine. In the historical comparison of 578 patients, those who received rapid biopsy-side-down positioning in addition to thrombin tract injection experienced pneumothorax in 11.0% of cases, compared with 24.5% among patients who received thrombin tract injection alone.
The research team, led by Baijintao Sun and colleagues, evaluated whether combining two preventive measures could lower these rates.
The study included patients who underwent CT-guided lung biopsy between May and December 2024 at a single center. A group of 478 patients received thrombin tract injection alone. A second group of 100 patients received the same injection plus rapid biopsy-side-down positioning, in which patients are quickly turned onto the side from which the biopsy was taken immediately after the procedure.
Beyond the difference in pneumothorax rates, the need for chest-tube placement was also lower in the positioning group: 5.0% versus 13.6% in the thrombin-only group. The researchers reported that both differences were statistically significant, with p-values of 0.003 for pneumothorax and 0.017 for chest-tube placement.
The study also examined which factors were associated with pneumothorax occurrence. Using multivariable logistic regression, the team found that a longer puncture path length increased the odds of pneumothorax, with a 10-millimeter increase associated with an odds ratio of 1.313 (95% confidence interval 1.142–1.511, p < 0.001).
Because some categories in the dataset contained very few events, the researchers performed a sensitivity analysis using Firth penalized logistic regression, a statistical method designed for sparse data. This analysis yielded broadly consistent associations, although the authors noted that estimates for sparse categories—particularly three needle adjustments and fissure puncture—remained imprecise.
The authors emphasized the limitations of their design. As a single-center retrospective historical comparison rather than a randomized trial, the study cannot establish that the positioning maneuver caused the lower complication rates, and unmeasured differences between the two patient groups may have influenced the results. The team concluded that prospective multicenter studies are needed to establish the efficacy and generalizability of the combined approach and to validate the observed associations between anatomical and procedural factors and pneumothorax.
Subject of Research: Prevention of pneumothorax after CT-guided lung biopsy using thrombin tract injection combined with rapid biopsy-side-down positioning
Article Title: Association of thrombin tract injection combined with rapid biopsy-side-down positioning with pneumothorax after CT-guided lung biopsy: a retrospective historical comparison
Article References: Sun, B., Li, B., Yan, G., Yang, Q., Yang, X., Li, Q., You, Y., Yu, X., Liu, Y., Zhang, C., & Yang, H. (2026). Association of thrombin tract injection combined with rapid biopsy-side-down positioning with pneumothorax after CT-guided lung biopsy: a retrospective historical comparison. BMC Pulmonary Medicine. https://doi.org/10.1186/s12890-026-04896-7
Image Credits: AI Generated
DOI: 10.1186/s12890-026-04896-7
Keywords: CT-guided lung biopsy, pneumothorax, thrombin tract injection, biopsy-side-down positioning, chest-tube placement, retrospective study, interventional radiology, lung lesions, emphysema, Firth penalized regression, BMC Pulmonary Medicine, Association
News Source: Ophelia Keating. (October 29, 2026). Simple Positioning Change After Lung Biopsy Linked to Fewer Collapsed Lungs in Retrospective Study. Scienmag.
