Is the rapid needle-out patient-rollover approach after CT-guided lung biopsy really effective for pneumothorax prevention?

Percutaneous CT-guided lung biopsy (PCLB) is a frequently performed procedure for sampling lung lesions. Pneumothorax is the most common complication of PCLB (range, 4-60%), requiring chest tube insertion in 0.2-8% procedures (1). Insertion of chest tube not only increases the procedure related morbidity, but also increases the hospital stay. Pneumothorax rates vary widely in different series depending on the technique, equipment used, size of lesions targeted and whether pneumothorax was defined on a chest X-ray or post procedure CT. High detection rate of pneumothorax on immediate post procedure CT scans are due to the high sensitivity of CT for detecting even very little pleural air.