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Percutaneous transthoracic needle biopsy of small (≤1 cm) lung nodules under C-arm cone-beam CT virtual navigation guidance

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Abstract

Objectives

To describe our initial experience with percutaneous transthoracic needle biopsy (PCNB) of small (≤1 cm) lung nodules using a cone-beam computed tomography (CBCT) virtual navigation guidance system in 105 consecutive patients.

Methods

One hundred and five consecutive patients (55 male, 50 female; mean age, 62 years) with 107 small (≤1 cm) lung nodules (mean size, 0.85 cm ± 0.14) underwent PCNBs under CBCT virtual-navigation guidance system and constituted our study population. Procedural details—including radiation dose, sensitivity, specificity, diagnostic accuracy and complication rates of CBCT virtual navigation guided PCNBs—were described.

Results

The mean number of pleural passages with the coaxial needle, biopsies, CT acquisitions, total procedure time, coaxial introducer dwelling time, and estimated radiation exposure during PCNBs were 1.03 ± 0.21, 3.1 ± 0.7, 3.4 ± 1.3, 10.5 min ± 3.2 and 7.2 min ± 2.5, and 5.72 mSv ± 4.19, respectively. Sixty nodules (56.1 %) were diagnosed as malignant, 38 (35.5 %) as benign and nine (8.4 %) as indeterminate. The sensitivity, specificity, and diagnostic accuracy of CBCT virtual-navigation-guided PCNB for small (≤1 cm) nodules were 96.7 % (58/60), 100 % (38/38) and 98.0 % (96/98), respectively. Complications occurred in 13 (12.1 %) cases; pneumothorax in seven (6.5 %) and haemoptysis in six (5.6 %).

Conclusion

CBCT virtual-navigation-guided PCNB is a highly accurate and safe diagnostic method for small (≤1 cm) nodules.

Key Points

• CBCT virtual-navigation guidance offers new biopsy options for lung nodules

• CBCT virtual-navigation-guided PCNB is highly accurate for small (≤1 cm) nodules

• CBCT virtual-navigation-guided PCNB for small (≤1 cm) nodules is safe

• Procedure time and radiation exposure of CBCT virtual-navigation-guided PCNB is reasonable

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Acknowledgements

This work was supported by the Industrial Strategic technology development program (grant number: 10041618) funded by the KoreanMinistry of Knowledge Economy.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101, Daehangno, Jongno-gu, Seoul, 110-744, South Korea

    Ji Yung Choo, Chang Min Park, Nyoung Keun Lee, Sang Min Lee, Hyun-Ju Lee & Jin Mo Goo

  2. Cancer Research Institute, Seoul National University, Seoul, South Korea

    Chang Min Park & Jin Mo Goo

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  1. Ji Yung Choo
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  2. Chang Min Park
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Corresponding author

Correspondence to Chang Min Park.

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Choo, J.Y., Park, C.M., Lee, N.K. et al. Percutaneous transthoracic needle biopsy of small (≤1 cm) lung nodules under C-arm cone-beam CT virtual navigation guidance. Eur Radiol 23, 712–719 (2013). https://doi.org/10.1007/s00330-012-2644-6

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