{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:55:45Z","timestamp":1787921745058,"version":"build-2784847793"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:00:00Z","timestamp":1724284800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:00:00Z","timestamp":1724284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008678","name":"Universit\u00e4t Leipzig","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008678","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Respir Res"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Iatrogenic pneumothorax is a relevant complication of computed tomography (CT)-guided percutaneous lung biopsy. The aim of the present study was to analyze the prognostic significance of texture analysis, emphysema score and muscle mass derived from CT-imaging to predict postinterventional pneumothorax after CT-guided lung biopsy. Consecutive patients undergoing CT-guided percutaneous lung biopsy between 2012 and 2021 were analyzed. Multivariate logistic regression analysis included clinical risk factors and CT-imaging features to detect associations with pneumothorax development. Overall, 479 patients (178 females, mean age 65\u2009\u00b1\u200911.7 years) underwent CT-guided percutaneous lung biopsy of which 180 patients (37.5%) developed pneumothorax including 55 patients (11.5%) requiring chest tube placement. Risk factors associated with pneumothorax were chronic-obstructive pulmonary disease (COPD) (<jats:italic>p<\/jats:italic>\u2009=\u20090.03), age (<jats:italic>p<\/jats:italic>\u2009=\u20090.02), total lung capacity (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and residual volume (<jats:italic>p<\/jats:italic>\u2009=\u20090.01) as well as interventional parameters needle length inside the lung (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), target lesion attached to pleura (<jats:italic>p<\/jats:italic>\u2009=\u20090.04), and intervention duration (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The combined model demonstrated a prediction accuracy of the occurrence of pneumothorax with an AUC of 0.78 [95%CI: 0.70\u20130.86] with a resulting sensitivity 0.80 and a specificity of 0.66. In conclusion, radiomics features of the target lesion and the lung lobe CT-emphysema score are predictive for the occurrence of pneumothorax and need for chest insertion after CT-guided lung biopsy.<\/jats:p>","DOI":"10.1186\/s12931-024-02936-6","type":"journal-article","created":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T13:34:13Z","timestamp":1724420053000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Impact of radiomics features, pulmonary emphysema score and muscle mass on the rate of pneumothorax and chest tube insertion in CT-guided lung biopsies"],"prefix":"10.1186","volume":"25","author":[{"given":"Jakob","family":"Leonhardi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Dahms","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Schnarkowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel Florian","family":"Struck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Kathrin","family":"H\u00f6hn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Kr\u00e4mer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Ebel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordian","family":"Prasse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin","family":"Frille","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timm","family":"Denecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Jonas","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,8,22]]},"reference":[{"key":"2936_CR1","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1097\/LBR.0b013e318272157d","volume":"19","author":"CR Dale","year":"2012","unstructured":"Dale CR, Madtes DK, Fan VS, Gorden JA, Veenstra DL, et al. Navigational bronchoscopy with biopsy versus computed tomography-guided biopsy for the diagnosis of a solitary pulmonary nodule: a cost-consequences analysis. J Bronchol Interv Pulmonol. 2012;19:294\u2013303.","journal-title":"J Bronchol Interv Pulmonol"},{"key":"2936_CR2","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1148\/radiol.2017170893","volume":"286","author":"KM Bhatt","year":"2018","unstructured":"Bhatt KM, Tandon YK, Graham R, et al. Electromagnetic navigational bronchoscopy versus CT-guided percutaneous sampling of Peripheral Indeterminate Pulmonary nodules: a Cohort Study. Radiology. 2018;286:1052\u201361.","journal-title":"Radiology"},{"key":"2936_CR3","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1007\/s00330-016-4357-8","volume":"27","author":"WJ Heerink","year":"2017","unstructured":"Heerink WJ, de Bock GH, de Jonge GJ, et al. Complication rates of CT-guided transthoracic lung biopsy: meta-analysis. Eur Radiol. 2017;27:138\u201348.","journal-title":"Eur Radiol"},{"key":"2936_CR4","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.ejrad.2006.02.001","volume":"59","author":"N Tomiyama","year":"2006","unstructured":"Tomiyama N, Yasuhara Y, Nakajima Y, et al. CT-guided needle biopsy of lung lesions: a survey of severe complication based on 9783 biopsies in Japan. Eur J Radiol. 2006;59:60\u20134.","journal-title":"Eur J Radiol"},{"key":"2936_CR5","doi-asserted-by":"publisher","first-page":"10978","DOI":"10.1038\/s41598-020-67348-0","volume":"10","author":"D Theilig","year":"2020","unstructured":"Theilig D, Petschelt D, Mayerhofer A, et al. Impact of quantitative pulmonary emphysema score on the rate of pneumothorax and chest tube insertion in CT-guided lung biopsies. Sci Rep. 2020;10:10978.","journal-title":"Sci Rep"},{"issue":"Suppl 1","key":"2936_CR6","first-page":"S99","volume":"6","author":"T Boskovic","year":"2014","unstructured":"Boskovic T, Stanic J, Pena-Karan S, et al. Pneumothorax after transthoracic needle biopsy of lung lesions under CT guidance. J Thorac Dis. 2014;6(Suppl 1):S99\u2013107.","journal-title":"J Thorac Dis"},{"key":"2936_CR7","doi-asserted-by":"publisher","first-page":"e407","DOI":"10.5114\/pjr.2018.79205","volume":"83","author":"K Ozturk","year":"2018","unstructured":"Ozturk K, Soylu E, Gokalp G, Topal U. Risk factors of pneumothorax and chest tube placement after computed tomography-guided core needle biopsy of lung lesions: a single-centre experience with 822 biopsies. Pol J Radiol. 2018;83:e407\u201314.","journal-title":"Pol J Radiol"},{"key":"2936_CR8","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.2214\/ajr.172.4.10587145","volume":"172","author":"F Laurent","year":"1999","unstructured":"Laurent F, Michel P, Latrabe V, et al. Pneumothoraces and chest tube placement after CT-guided transthoracic lung biopsy using a coaxial technique: incidence and risk factors. AJR Am J Roentgenol. 1999;172:1049\u201353.","journal-title":"AJR Am J Roentgenol"},{"key":"2936_CR9","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1016\/S0720-048X(03)00058-5","volume":"48","author":"U Topal","year":"2003","unstructured":"Topal U, Ediz B. Transthoracic needle biopsy: factors effecting risk of pneumothorax. Eur J Radiol. 2003;48:263\u20137.","journal-title":"Eur J Radiol"},{"key":"2936_CR10","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1148\/radiology.212.1.r99jl33165","volume":"212","author":"JE Cox","year":"1999","unstructured":"Cox JE, Chiles C, McManus CM, Aquino SL, Choplin RH. Transthoracic needle aspiration biopsy: variables that affect risk of pneumothorax. Radiology. 1999;212:165\u20138.","journal-title":"Radiology"},{"key":"2936_CR11","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1007\/s11604-019-00880-w","volume":"37","author":"DS Lee","year":"2019","unstructured":"Lee DS, Bak SH, Jeon YH, Kwon SO, Kim WJ. Perilesional emphysema as a predictor of risk of complications from computed tomography-guided transthoracic lung biopsy. Jpn J Radiol. 2019;37:808\u201316.","journal-title":"Jpn J Radiol"},{"key":"2936_CR12","doi-asserted-by":"publisher","first-page":"805","DOI":"10.3390\/ijms18040805","volume":"18","author":"M Incoronato","year":"2017","unstructured":"Incoronato M, Aiello M, Infante T, et al. Radiogenomic Analysis of Oncological Data: a technical Survey. Int J Mol Sci. 2017;18:805.","journal-title":"Int J Mol Sci"},{"key":"2936_CR13","doi-asserted-by":"publisher","first-page":"2205","DOI":"10.1038\/bjc.2014.512","volume":"9","author":"N Just","year":"2014","unstructured":"Just N. Improving tumour heterogeneity MRI assessment with histograms. Br J Cancer. 2014;9:111:2205\u201313.","journal-title":"Br J Cancer"},{"key":"2936_CR14","doi-asserted-by":"publisher","first-page":"3961","DOI":"10.1007\/s00259-021-05242-1","volume":"48","author":"G Wu","year":"2021","unstructured":"Wu G, Jochems A, Refaee T, et al. Structural and functional radiomics for lung cancer. Eur J Nucl Med Mol Imaging. 2021;48:3961\u201374.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"2936_CR15","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1016\/j.ejca.2011.11.036","volume":"48","author":"P Lambin","year":"2012","unstructured":"Lambin P, Rios-Velazquez E, Leijenaar R, et al. Radiomics: extracting more information from medical images using advanced feature analysis. Eur J Cancer. 2012;48:441\u20136.","journal-title":"Eur J Cancer"},{"key":"2936_CR16","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00128","author":"D Baldwin","year":"2023","unstructured":"Baldwin D, O\u2019Dowd E, Tietzova I, et al. Developing a Pan-european technical standard for a comprehensive high-quality lung cancer CT screening program. An ERS technical standard. Eur Respir J. 2023:61:2300128. https:\/\/doi.org\/10.1183\/13993003.00128.","journal-title":"Eur Respir J"},{"key":"2936_CR17","unstructured":"Global initiative for chronic obstructive lung disease. The Global Strategy for Diagnosis, Management and Prevention of COPD (updated 2023). www.goldcopd.org. Accessed 1st June 2023."},{"key":"2936_CR18","doi-asserted-by":"publisher","first-page":"e70","DOI":"10.1164\/rccm.201908-1590ST","volume":"200","author":"BL Graham","year":"2019","unstructured":"Graham BL, Steenbruggen I, Miller MR, et al. Standardization of Spirometry 2019 Update. An official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med. 2019;200:e70\u201388.","journal-title":"Am J Respir Crit Care Med"},{"key":"2936_CR19","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.1164\/rccm.201710-1981ST","volume":"196","author":"BH Culver","year":"2017","unstructured":"Culver BH, Graham BL, Coates AL, et al. Recommendations for a standardized pulmonary function report. An Official American Thoracic Society Technical Statement. Am J Respir Crit Care Med. 2017;196:1463\u201372.","journal-title":"Am J Respir Crit Care Med"},{"key":"2936_CR20","doi-asserted-by":"publisher","first-page":"1694","DOI":"10.4187\/respcare.02786","volume":"58","author":"MD Davis","year":"2013","unstructured":"Davis MD, Walsh BK, Sittig SE, Restrepo RD. AARC clinical practice guideline: blood gas analysis and hemoximetry: 2013. Respir Care. 2013;58:1694\u2013703.","journal-title":"Respir Care"},{"key":"2936_CR21","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1016\/j.diii.2016.06.016","volume":"97","author":"C de Margerie-Mellon","year":"2016","unstructured":"de Margerie-Mellon C, de Bazelaire C, de Kerviler E. Image-guided biopsy in primary lung cancer: why, when and how. Diagn Interv Imaging. 2016;97:965\u201372.","journal-title":"Diagn Interv Imaging"},{"key":"2936_CR22","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1007\/s00330-012-2683-z","volume":"23","author":"Z Wang","year":"2013","unstructured":"Wang Z, Gu S, Leader JK, et al. Optimal threshold in CT quantification of emphysema. Eur Radiol. 2013;23:975\u201384.","journal-title":"Eur Radiol"},{"issue":"4","key":"2936_CR23","doi-asserted-by":"publisher","first-page":"2199","DOI":"10.1007\/s00330-019-06573-2","volume":"30","author":"D Albano","year":"2020","unstructured":"Albano D, Messina C, Vitale J, Sconfienza LM. Imaging of Sarcopenia: old evidence and new insights. Eur Radiol. 2020;30(4):2199\u2013208.","journal-title":"Eur Radiol"},{"key":"2936_CR24","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.cmpb.2008.08.005","volume":"94","author":"PM Szczypi\u0144ski","year":"2009","unstructured":"Szczypi\u0144ski PM, Strzelecki M, Materka A, Klepaczko A. MaZda\u2014a software package for image texture analysis. Comput Methods Prog Biomed. 2009;94:66\u201376.","journal-title":"Comput Methods Prog Biomed"},{"key":"2936_CR25","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.nima.2012.09.006","volume":"702","author":"M Strzelecki","year":"2013","unstructured":"Strzelecki M, Szczypinski P, Materka A, Klepaczko A. A software tool for automatic classification and segmentation of 2D\/3D medical images. Nucl Instrum Methods Phys Res A. 2013;702:137\u201340.","journal-title":"Nucl Instrum Methods Phys Res A"},{"key":"2936_CR26","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.1002\/nbm.2962","volume":"26","author":"J Fruehwald-Pallamar","year":"2013","unstructured":"Fruehwald-Pallamar J, Czerny C, Holzer-Fruehwald L, et al. Texture-based and diffusion-weighted discrimination of parotid gland lesions on MR images at 3.0 Tesla. NMR Biomed. 2013;26:1372\u20139.","journal-title":"NMR Biomed"},{"key":"2936_CR27","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1016\/j.tranon.2017.09.003","volume":"10","author":"HJ Meyer","year":"2017","unstructured":"Meyer HJ, Schob S, H\u00f6hn AK, Surov A. MRI texture analysis reflects histopathology parameters in thyroid Cancer - A First Preliminary Study. Transl Oncol. 2017;10:911\u20136.","journal-title":"Transl Oncol"},{"key":"2936_CR28","doi-asserted-by":"publisher","first-page":"5404","DOI":"10.21037\/qims-22-176","volume":"12","author":"Y Zhao","year":"2022","unstructured":"Zhao Y, Bao D, Wu W, Tang W, Xing G, Zhao X. Development and validation of a prediction model of pneumothorax after CT-guided coaxial core needle lung biopsy. Quant Imaging Med Surg. 2022;12:5404\u201319.","journal-title":"Quant Imaging Med Surg"},{"key":"2936_CR29","doi-asserted-by":"publisher","first-page":"e0213990","DOI":"10.1371\/journal.pone.0213990","volume":"14","author":"AS Elshafee","year":"2019","unstructured":"Elshafee AS, Karch A, Ringe KI, et al. Complications of CT-guided lung biopsy with a non-coaxial semi-automated 18 gauge biopsy system: frequency, severity and risk factors. PLoS ONE. 2019;14:e0213990.","journal-title":"PLoS ONE"},{"key":"2936_CR30","doi-asserted-by":"publisher","first-page":"1382","DOI":"10.1016\/j.crad.2015.08.003","volume":"70","author":"HA Chami","year":"2015","unstructured":"Chami HA, Faraj W, Yehia ZA, et al. Predictors of pneumothorax after CT-guided transthoracic needle lung biopsy: the role of quantitative CT. Clin Radiol. 2015;70:1382\u20137.","journal-title":"Clin Radiol"},{"key":"2936_CR31","doi-asserted-by":"publisher","first-page":"e0178078","DOI":"10.1371\/journal.pone.0178078","volume":"12","author":"D Lendeckel","year":"2017","unstructured":"Lendeckel D, Kromrey ML, Ittermann T, et al. Pulmonary emphysema is a predictor of pneumothorax after CT-guided transthoracic pulmonary biopsies of pulmonary nodules. PLoS ONE. 2017;12:e0178078.","journal-title":"PLoS ONE"},{"key":"2936_CR32","doi-asserted-by":"publisher","first-page":"153303382210853","DOI":"10.1177\/15330338221085357","volume":"21","author":"W An","year":"2022","unstructured":"An W, Zhang H, Wang B, Zhong F, Wang S, Liao M. Comparison of CT-Guided core needle biopsy in Pulmonary Ground-Glass and solid nodules based on propensity score matching analysis. Technol Cancer Res Treat. 2022;21:15330338221085357.","journal-title":"Technol Cancer Res Treat"},{"key":"2936_CR33","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.4103\/jcrt.jcrt_1058_21","volume":"17","author":"W Zhou","year":"2021","unstructured":"Zhou W, Yu X, Song Y, et al. Risk of pneumothorax caused by computerized tomography-guided percutaneous core needle biopsy of the lung in elderly and young patients. J Cancer Res Ther. 2021;17:1186\u201391.","journal-title":"J Cancer Res Ther"},{"key":"2936_CR34","doi-asserted-by":"publisher","first-page":"707","DOI":"10.21037\/qims-22-474","volume":"13","author":"B Peng","year":"2023","unstructured":"Peng B, Deng Z, Wang Y, et al. The risk of immediate pneumothorax after CT-guided lung needle biopsy: pleural tail sign as a novel factor. Quant Imaging Med Surg. 2023;13:707\u201319.","journal-title":"Quant Imaging Med Surg"},{"key":"2936_CR35","doi-asserted-by":"publisher","first-page":"4243","DOI":"10.1007\/s00330-020-07449-6","volume":"31","author":"EA Ruud","year":"2021","unstructured":"Ruud EA, Stavem K, Geitung JT, et al. Predictors of pneumothorax and chest drainage after percutaneous CT-guided lung biopsy: a prospective study. Eur Radiol. 2021;31:4243\u201352.","journal-title":"Eur Radiol"},{"key":"2936_CR36","doi-asserted-by":"crossref","unstructured":"Nagarajan G, Doshi P, Bardeskar NS, Kulkarni A, Punamiya A, Tongaonkar H. Association between Sarcopenia and postoperative complications in patients undergoing surgery for gastrointestinal or hepato-pancreatico-biliary cancer. J Surg Oncol. 2023;128:708\u201310","DOI":"10.1002\/jso.27315"},{"key":"2936_CR37","unstructured":"Xiong B, Yang C, Zhu X et al. The added value of Sarcopenia on existing risk scores to Predict Mortality after TIPS Placement: a Multicenter Study. Acad Radiol 2023;S1076-6332(23)00123-X."},{"key":"2936_CR38","doi-asserted-by":"publisher","first-page":"790","DOI":"10.3390\/cancers15030790","volume":"15","author":"A Hasenauer","year":"2023","unstructured":"Hasenauer A, Forster C, Hungerb\u00fchler J, et al. CT-Derived Sarcopenia and outcomes after Thoracoscopic Pulmonary Resection for Non-small Cell Lung Cancer. Cancers (Basel). 2023;15:790.","journal-title":"Cancers (Basel)"}],"container-title":["Respiratory Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12931-024-02936-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12931-024-02936-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12931-024-02936-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T13:36:43Z","timestamp":1724420203000},"score":1,"resource":{"primary":{"URL":"https:\/\/respiratory-research.biomedcentral.com\/articles\/10.1186\/s12931-024-02936-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,22]]},"references-count":38,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2936"],"URL":"https:\/\/doi.org\/10.1186\/s12931-024-02936-6","relation":{},"ISSN":["1465-993X"],"issn-type":[{"value":"1465-993X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,22]]},"assertion":[{"value":"2 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 August 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The study was approved by the University of Leipzig Review Board.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}],"article-number":"320"}}