Clinical Radiology Audit and Quality Improvement ePoster Competitions 2026

Autologous Blood Patch Improves Lung Biopsy Performance: A Quality Improvement Project

Introduction

•CT-guided lung biopsy is essential for the diagnosis of lung cancer.

•Key complications include pneumothorax, bleeding, air embolism and death.

•Aim: Improve safety while maintaining diagnostic adequacy.

•Intervention: Introduction of autologous blood patch technique.

Method

1st audit: 131 CT-guided lung biopsies over 12 months.

2nd audit: Autologous blood patch introduced. 112 biopsy cases audited.

Data sources: Soliton, PACS and PowerChart.

Outcomes: pneumothorax, chest drain insertion, inpatient stay and diagnostic adequacy.

Statistical tests: Chi-square, Mann-Whitney and unpaired t-test.

Key Findings

• Significant pneumothorax reduced from 24% to 12% (p = 0.01).

• Chest drain insertion reduced from 11% to 2% (p = 0.005).

• Inpatient stay reduced from 0.7 to 0.2 days per procedure (p = 0.006).

• Significant savings of 56.4 inpatient nights over 18 months.

What is autologous blood patch technique?

•(Image 1) A sample of venous blood is obtained from the patient before procedure

•(Image 2) After the biopsy, the same venous blood is injected along the biopsy tract and at the site of pleural puncture.

•The purpose of the blood patch is to seal the puncture site, rapidly form a clot and reduce the risk of pneumothorax.

Improvements, but at what cost?

•Total cost for a blood patch

10 mLs syringe (22 p) + plastic bung (6 p) = 28p

28 p x 112 procedures = £31.36

•0.7 inpatients days per case reduced to 0.2

•56.4 expected inpatient nights saved over 18 months

•56.4 nights at £450 per night -> £25,380

-> £25,380 - £31.36

CUH saved £25,348.64.

Conclusion

Following the introduction of autologous blood patch injections, CUH radiology demonstrates excellent lung biopsy performance exceeding RCR standards.

Blood patch injection reduces risk of pneumothorax (12% vs. 24%, p = 0.01) and reduces inpatient days per procedure (0.2 compared 0.7, p = 0.006).

While autologous blood patch injection is not formally part of BTS or RCR guidance, given the statistically significant improvements, it is now standard practice at CUH Radiology.

Action Plan

Communicate findings at local CG and CUH R&D day

Formalise a written SOP for lung biopsy

Contact vendor for upgrade on current biopsy devices

Re-audit in 18 months

Clinical Radiology Audit and Quality Improvement ePoster Competitions 2026

Autologous Blood Patch Injection Improves Safety and Diagnostic Yield in CT-Guided Lung Biopsy: A Two-Cycle Quality Improvement Project

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