Autologous blood patch injection versus hydrogel plug in CT-guided lung biopsy: A prospective randomized trial Journal Article

Authors: Maybody, M.; Muallem, N.; Brown, K. T.; Moskowitz, C. S.; Hsu, M.; Zenobi, C. L.; Jihad, M.; Getrajdman, G. I.; Sofocleous, C. T.; Erinjeri, J. P.; Covey, A. M.; Brody, L. A.; Yarmohammadi, H.; Deipolyi, A. R.; Bryce, Y.; Alago, W.; Siegelbaum, R. H.; Durack, J. C.; Gonzalez-Aguirre, A. J.; Ziv, E.; Boas, F. E.; Solomon, S. B.
Article Title: Autologous blood patch injection versus hydrogel plug in CT-guided lung biopsy: A prospective randomized trial
Abstract: Purpose To compare the effect of autologous blood patch injection (ABPI) with that of a hydrogel plug on the rate of pneumothorax at CT-guided percutaneous lung biopsy. Materials and Methods In this prospective randomized controlled trial ( , NCT02224924), a noninferiority design was used for ABPI, with a 10% noninferiority margin when compared with the hydrogel plug, with the primary outcome of pneumothorax rate within 2 hours of biopsy. A type I error rate of 0.05 and 90% power were specified with a target study population of 552 participants (276 in each arm). From October 2014 to February 2017, all potential study participants referred for CT-guided lung biopsy (n = 2052) were assessed for enrollment. Results The data safety monitoring board recommended the trial be closed to accrual after an interim analysis met prespecified criteria for early stopping based on noninferiority. The final study group consisted of 453 participants who were randomly assigned to the ABPI (n = 226) or hydrogel plug (n = 227) arms. Of these, 407 underwent lung biopsy. Pneumothorax rates within 2 hours of biopsy were 21% (42 of 199) and 29% (60 of 208); chest tube rates were 9% (18 of 199) and 13% (27 of 208); and delayed pneumothorax rates within 2 weeks after biopsy were 1.4% (three of 199) and 1.5% (three of 208) in the ABPI and hydrogel plug arms, respectively. Conclusion Autologous blood patch injection is noninferior to a hydrogel plug regarding the rate of pneumothorax after CT-guided percutaneous lung biopsy. © RSNA, 2018 Online supplemental material is available for this article.
Journal Title: Radiology
Volume: 290
Issue: 2
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2019-02-01
Start Page: 547
End Page: 554
Language: English
DOI: 10.1148/radiol.2018181140
PUBMED: 30480487
PROVIDER: scopus
PMCID: PMC6357949
Notes: Article -- Export Date: 1 March 2019 -- Source: Scopus
Citation Impact
MSK Authors
  1. William Alago
    25 Alago
  2. Meier Hsu
    125 Hsu
  3. Anne Covey
    137 Covey
  4. Chaya S. Moskowitz
    203 Moskowitz
  5. Majid Maybody
    77 Maybody
  6. Lynn Brody
    103 Brody
  7. Karen T Brown
    172 Brown
  8. Stephen Solomon
    312 Solomon
  9. Joseph Patrick Erinjeri
    116 Erinjeri
  10. Jeremy Charles Durack
    99 Durack
  11. Franz Edward Boas
    54 Boas
  12. Etay   Ziv
    41 Ziv
  13. Yolanda Bryce
    17 Bryce
  14. Christina Lynn Zenobi
    1 Zenobi
  15. Marwah Jihad
    2 Jihad