{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:18:16Z","timestamp":1790266696678,"version":"4.1.0"},"reference-count":39,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T00:00:00Z","timestamp":1701129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>This study aimed to assess the effectiveness of saline sealing in reducing the incidence of pneumothorax after a CT-guided lung biopsy. This was a retrospective case-control study of patients who underwent CT-guided biopsies for lung tumors using 18 G semiautomatic core needles in conjunction with 17 G coaxial needles. The patients were divided into two consecutive groups: a historical Group A (n = 111), who did not receive saline sealing, and Group B (n = 87), who received saline sealing. In Group B, NaCl 0.9% was injected through the coaxial needle upon its removal. The incidence of pneumothorax and chest tube insertion was compared between the two groups. Multivariate logistic regression was performed to verify the contribution of other pneumothorax risk factors. The study included 198 patients, with 111 in Group A and 87 in Group B. There was a significantly (p = 0.02) higher pneumothorax rate in Group A (35.1%, n = 39) compared to Group B (20.7%, n = 18). The difference regarding chest tube insertion was not significant (p = 0.1), despite a tendency towards more insertions in Group A (5.4%, n = 6), compared to Group B (1.1%, n = 1). Among the risk factors for pneumothorax, only the presence of emphysema (OR = 3.5, p = 0.0007) and belonging to Group A (OR = 2.2, p = 0.02) were significant. Saline sealing of the needle tract after a CT-guided lung biopsy can significantly reduce the incidence of pneumothorax. This technique is safe, readily available, and inexpensive, and should be considered as a routine preventive measure during this procedure.<\/jats:p>","DOI":"10.3390\/diagnostics13233546","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T07:40:01Z","timestamp":1701157201000},"page":"3546","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Usefulness of Saline Sealing in Preventing Pneumothorax after CT-Guided Biopsies of the Lung"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5340-5325","authenticated-orcid":false,"given":"Andrei","family":"Roman","sequence":"first","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania"},{"name":"Department of Radiology, Oncology Institute \u201cProf. Dr. Ion Chiricuta\u201d, 400015 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea","family":"Brozba","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4030-1698","authenticated-orcid":false,"given":"Alexandru","family":"Necula","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delia Doris","family":"Muntean","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania"},{"name":"Department of Radiology, Cluj County Emergency Hospital, 400347 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7957-9796","authenticated-orcid":false,"given":"Paul","family":"Kubelac","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania"},{"name":"Department of Oncology, Oncology Institute \u201cProf. Dr. Ion Chiricuta\u201d, 400015 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3386-8263","authenticated-orcid":false,"given":"Zsolt","family":"Fekete","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania"},{"name":"Department of Radiotherapy, Oncology Institute \u201cProf. Dr. Ion Chiricuta\u201d, 400015 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5500-1519","authenticated-orcid":false,"given":"Ciprian","family":"Tomuleasa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania"},{"name":"Department of Hematology, Oncology Institute \u201cProf. Dr. Ion Chiricuta\u201d, 400015 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csaba","family":"Csutak","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania"},{"name":"Department of Radiology, Cluj County Emergency Hospital, 400347 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Feier","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania"},{"name":"Department of Radiology, Cluj County Emergency Hospital, 400347 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2222-3219","authenticated-orcid":false,"given":"Roxana","family":"Pintican","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania"},{"name":"Department of Radiology, Cluj County Emergency Hospital, 400347 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catalin","family":"Vlad","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania"},{"name":"Department of Surgery, Oncology Institute \u201cProf. Dr. Ion Chiricuta\u201d, 400015 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1016\/j.cllc.2016.03.004","article-title":"Assessment of Selection Criteria for Low-Dose Lung Screening CT Among Asian Ethnic Groups in Taiwan: From Mass Screening to Specific Risk-Based Screening for Non-Smoker Lung Cancer","volume":"17","author":"Wu","year":"2016","journal-title":"Clin. Lung Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Wolf, A.M.D., Oeffinger, K.C., Shih, T.Y.-C., Walter, L.C., Church, T.R., Fontham, E.T.H., Elkin, E.B., Etzioni, R.D., Guerra, C.E., and Perkins, R.B. (2023). Screening for lung cancer: 2023 guideline update from the American Cancer Society. CA Cancer J. Clin.","DOI":"10.3322\/caac.21811"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1093\/annonc\/mdu089","article-title":"2nd ESMO Consensus Conference on Lung Cancer: Early-stage non-small-cell lung cancer consensus on diagnosis, treatment and follow-up","volume":"25","author":"Vansteenkiste","year":"2014","journal-title":"Ann. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.2217\/fon-2018-0527","article-title":"Transthoracic computed tomography-guided lung biopsy in the new era of personalized medicine","volume":"15","author":"Russo","year":"2019","journal-title":"Future Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.carj.2015.10.005","article-title":"Transthoracic Computed Tomography-Guided Lung Nodule Biopsy: Comparison of Core Needle and Fine Needle Aspiration Techniques","volume":"67","author":"Sangha","year":"2016","journal-title":"Can. Assoc. Radiol. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1016\/j.jvir.2016.01.134","article-title":"Diagnostic Accuracy and Safety of CT-Guided Percutaneous Transthoracic Needle Biopsies: 14-Gauge versus 22-Gauge Needles","volume":"27","author":"Ocak","year":"2016","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e29016","DOI":"10.1097\/MD.0000000000029016","article-title":"Comparison between computed tomography-guided core and fine needle lung biopsy: A meta-analysis","volume":"101","author":"Li","year":"2022","journal-title":"Medicine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1309\/AJCPMY8UI7WSFSYY","article-title":"Adequacy of core needle biopsy specimens and fine-needle aspirates for molecular testing of lung adenocarcinomas","volume":"143","author":"Schneider","year":"2015","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"263","DOI":"10.3348\/kjr.2020.0137","article-title":"2020 Clinical Practice Guideline for Percutaneous Transthoracic Needle Biopsy of Pulmonary Lesions: A Consensus Statement and Recommendations of the Korean Society of Thoracic Radiology","volume":"22","author":"Yoon","year":"2021","journal-title":"Korean J. Radiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1148\/radiol.2291020499","article-title":"CT-guided Transthoracic Needle Aspiration Biopsy of Pulmonary Nodules: Needle Size and Pneumothorax Rate","volume":"229","author":"Geraghty","year":"2003","journal-title":"Radiology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"20210065","DOI":"10.1259\/bjr.20210065","article-title":"Diagnostic accuracy and complication rate of image-guided percutaneous transthoracic needle lung biopsy for subsolid pulmonary nodules: A systematic review and meta-analysis","volume":"94","author":"Kim","year":"2021","journal-title":"Br. J. Radiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1007\/s11547-013-0360-1","article-title":"Trans-thoracic biopsy of lung lesions: FNAB or CNB? Our experience and review of the literature","volume":"119","author":"Capalbo","year":"2014","journal-title":"Radiol. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"20190866","DOI":"10.1259\/bjr.20190866","article-title":"Pneumothorax rates in CT-Guided lung biopsies: A comprehensive systematic review and meta-analysis of risk factors","volume":"93","author":"Huo","year":"2020","journal-title":"Br. J. Radiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1007\/s00330-016-4357-8","article-title":"Complication rates of CT-guided transthoracic lung biopsy: Meta-analysis","volume":"27","author":"Heerink","year":"2017","journal-title":"Eur. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.2214\/AJR.08.2113","article-title":"CT-guided core biopsy of lung lesions: A primer","volume":"193","author":"Tsai","year":"2009","journal-title":"AJR. Am. J. Roentgenol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1148\/radiology.216.1.r00jl3293","article-title":"Autologous blood clot seal to prevent pneumothorax at CT-guided lung biopsy","volume":"216","author":"Lang","year":"2000","journal-title":"Radiology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1007\/s00270-019-02196-8","article-title":"Post-Biopsy Manoeuvres to Reduce Pneumothorax Incidence in CT-Guided Transthoracic Lung Biopsies: A Systematic Review and Meta-analysis","volume":"42","author":"Huo","year":"2019","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s43055-022-00950-6","article-title":"Does Gelfoam slurry embolization post-pulmonary biopsy reduce risk of pneumothorax? A prospective randomized control study","volume":"54","author":"Salama","year":"2023","journal-title":"Egypt. J. Radiol. Nucl. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e673","DOI":"10.1016\/j.crad.2022.05.019","article-title":"Biopsy-tract haemocoagulase injection reduces major complications after CT-guided percutaneous transthoracic lung biopsy","volume":"77","author":"Zhou","year":"2022","journal-title":"Clin. Radiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1016\/j.jvir.2021.06.022","article-title":"Percutaneous Lung Biopsy with Pleural and Parenchymal Blood Patching: Results and Complications from 1112 Core Biopsies","volume":"32","author":"Zlevor","year":"2021","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.ejrad.2019.04.010","article-title":"The effect of intraparenchymal blood patching on the rate of pneumothorax in patients undergoing percutaneous CT-guided core biopsy of the lung","volume":"116","author":"Perl","year":"2019","journal-title":"Eur. J. Radiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1148\/radiol.2018181140","article-title":"Autologous Blood Patch Injection versus Hydrogel Plug in CT-guided Lung Biopsy: A Prospective Randomized Trial","volume":"290","author":"Maybody","year":"2019","journal-title":"Radiology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1007\/s00330-015-3601-y","article-title":"Rapid needle-out patient-rollover approach after cone beam CT-guided lung biopsy: Effect on pneumothorax rate in 1191 consecutive patients","volume":"25","author":"Kim","year":"2015","journal-title":"Eur. Radiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1007\/s00330-008-0872-6","article-title":"CT-guided lung biopsy: Incidence of pneumothorax after instillation of NaCl into the biopsy track","volume":"18","author":"Billich","year":"2008","journal-title":"Eur. Radiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1016\/j.crad.2015.06.081","article-title":"Usefulness of normal saline for sealing the needle track after CT-guided lung biopsy","volume":"70","author":"Li","year":"2015","journal-title":"Clin. Radiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.carj.2018.08.002","article-title":"Injection of Saline Into the Biopsy Tract and Rapid Patient Rollover Decreases Pneumothorax Size Following Computed Tomography-Guided Transthoracic Needle Biopsy","volume":"69","author":"Khorochkov","year":"2018","journal-title":"Can. Assoc. Radiol. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1111\/1754-9485.13002","article-title":"Tract sealing with normal saline after percutaneous transthoracic lung biopsies","volume":"64","author":"Babu","year":"2020","journal-title":"J. Med. Imaging Radiat. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.jvir.2012.02.012","article-title":"Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions","volume":"23","author":"Patel","year":"2012","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1148\/radiol.2015141579","article-title":"CT-Definable Subtypes of Chronic Obstructive Pulmonary Disease: A Statement of the Fleischner Society","volume":"277","author":"Lynch","year":"2015","journal-title":"Radiology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1148\/radiol.2019182321","article-title":"CT-guided Lung Biopsy: Effect of Biopsy-side Down Position on Pneumothorax and Chest Tube Placement","volume":"292","author":"Drumm","year":"2019","journal-title":"Radiology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1148\/radiol.11103506","article-title":"Rapid needle-out patient-rollover time after percutaneous CT-guided transthoracic biopsy of lung nodules: Effect on pneumothorax rate","volume":"262","author":"McCarthy","year":"2012","journal-title":"Radiology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.ejrad.2012.09.013","article-title":"Breath-hold after forced expiration before removal of the biopsy needle decreased the rate of pneumothorax in CT-guided transthoracic lung biopsy","volume":"82","author":"Min","year":"2013","journal-title":"Eur. J. Radiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1097\/RTI.0000000000000215","article-title":"Nonclotted Blood Patch Technique Reduces Pneumothorax and Chest Tube Placement Rates after Percutaneous Lung Biopsies","volume":"31","author":"Clayton","year":"2016","journal-title":"J. Thorac. Imaging"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/S0003-4975(10)62816-0","article-title":"Complications of transthoracic needle biopsy decreased with isobutyl 2-cyanoacrylate: A pilot study","volume":"43","author":"Skupin","year":"1987","journal-title":"Ann. Thorac. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"470","DOI":"10.5152\/dir.2020.19202","article-title":"Effectiveness of autologous blood injection in reducing the rate of pneumothorax after percutaneous lung core needle biopsy","volume":"26","author":"Turgut","year":"2020","journal-title":"Diagn. Interv. Radiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1136\/thorax.58.11.920","article-title":"Guidelines for radiologically guided lung biopsy","volume":"58","author":"Manhire","year":"2003","journal-title":"Thorax"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"421","DOI":"10.5152\/dir.2014.14019","article-title":"CT-guided biopsy of pulmonary nodules: Is pulmonary hemorrhage a complication or an advantage?","volume":"20","author":"Saba","year":"2014","journal-title":"Diagn. Interv. Radiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"21","DOI":"10.5334\/jbsr.1591","article-title":"Effect of Needle-Tract Bleeding on Pneumothorax and Chest Tube Placement Following CT Guided Core Needle Lung Biopsy","volume":"103","author":"Soylu","year":"2019","journal-title":"J. Belg. Soc. Radiol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/23\/3546\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:31:57Z","timestamp":1760131917000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/23\/3546"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,28]]},"references-count":39,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["diagnostics13233546"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13233546","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,28]]}}}