ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1642860
Risk Factors and Nomogram Prediction Model for Pneumothorax After CT-Guided Coaxial Biopsy Combined with Microwave Ablation in Ground-Glass Nodules
Provisionally accepted
- Longyan First Hospital, Longyan, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: To investigate the influencing factors of pneumothorax following simultaneous coaxial biopsy and microwave ablation (MWA) under CT guidance in patients with ground-glass nodules (GGNs), and to establish and validate a predictive model using logistic regression and nomogram analysis with factor importance ranking. Methods: A retrospective analysis was conducted on 383 GGN patients who underwent CT-guided coaxial biopsy combined with microwave ablation in our hospital from January 2022 to December 2024, who were divided into a training set (n=268) and a validation set (n=115) in a 7:3 ratio. Univariate and multivariate logistic regression were employed to identify risk factors, followed by the construction of a nomogram model. Receiver operating characteristic (ROC) curves and calibration plots were generated to evaluate model performance, with further validation in the independent cohort. Decision curve analysis (DCA) was applied to assess clinical utility. Results: Pneumothorax occurred in 72 cases (26.87%) in the training set and 32 cases (27.83%) in the validation set. Multivariate logistic regression revealed that BMI, lesion location, lesion depth, needle diameter, and number of punctures were independent risk factors for pneumothorax (all P <0.05). Factor importance ranking was as follows: number of punctures > BMI > lesion depth > lesion location > needle diameter. The nomogram demonstrated robust calibration and predictive accuracy, with C-index values of 0.877 (training set) and 0.897 (validation set). The areas under the ROC curve (AUC) were 0.875 (95% CI: 0.825-0.926) and 0.897 (95% CI: 0.829-0.965), respectively. Sensitivity and specificity were 0.855/0.813 (training set) and 0.765/0.823 (validation set). Conclusion: Key determinants of postprocedural pneumothorax in GGN patients were identified through logistic regression and nomogram modeling. The validated predictive model exhibited excellent discriminative ability and clinical applicability, providing a scientific basis for individualized risk assessment and intervention strategies.
Keywords: Ground-glass nodule, CT-guided percutaneous biopsy, Microwave ablation, Pneumothorax, Logistic regression, Nomogram model
Received: 07 Jun 2025; Accepted: 10 Jul 2025.
Copyright: © 2025 Wu, Zhao, Chen and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jun Ma, Longyan First Hospital, Longyan, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.