How Effective Is Saline Solution Infiltration During Coaxial Needle Withdrawal in Reducing the Incidence of Pneumothorax in CT-Guided Lung Biopsies?

Background/Objectives: This study evaluates whether saline infiltration during coaxial needle withdrawal reduces the incidence of pneumothorax (PTX) in CT-guided lung biopsies, potentially enhancing procedural safety. Methods: A retrospective analysis of 200 consecutive CT-guided core needle biopsies (18G) was conducted using our hospital’s Radiology Department database. All procedures were performed between February 2022 and December 2024 by a single operator with 20 years of experience. Patients were divided into two groups: Group A (100 patients), receiving 10 mL of 0.9% saline solution during coaxial needle withdrawal, and Group B (100 patients), in whom no saline was infiltrated. Descriptive and inferential statistical analyses were used to assess the relationship between saline infiltration and the incidence of PTX. Results: PTX occurred in 24% of Group B patients versus 7% in Group A (p = 0.001). Multivariate analysis identified saline infiltration as a significant protective factor, even in high-risk patients (e.g., those with emphysema or in lateral decubitus). The odds ratio (OR = 0.18; 95% CI: 0.07–0.48) indicates that saline infiltration significantly reduces the risk of PTX. Conclusions: Infiltration of 10 mL of saline during coaxial needle withdrawal significantly reduces the incidence of PTX in CT-guided lung biopsies, offering a simple and effective strategy to enhance patient safety.