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Initial experience of percutaneous transthoracic needle biopsy of lung nodules using C-arm cone-beam CT systems

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Abstract

Objective

To describe our initial experience with percutaneous transthoracic biopsy (PCNB) of lung nodules using C-arm cone-beam CT (CBCT).

Materials

Seventy-one consecutive patients with lung nodules of 30 mm or smaller underwent CBCT-guided PCNB using a coaxial cutting needle. We evaluated the procedure time, coaxial introducer dwell time, the numbers of pleural passages, coaxial introducer repositionings and CT acquisitions, as well as the technical success rate and radiation doses. Diagnostic accuracy, sensitivity, specificity and incidence of complications were also evaluated.

Results

PCNB was performed for 71 nodules: 63 solid, 6 part-solid and 2 ground-glass nodules. The procedure time, coaxial introducer dwell time, numbers of pleural passages, coaxial introducer repositionings and CT acquisitions were 17.9 ± 5.9 min, 8.7 ± 3.8 min, 1.1 ± 0.4, 0.2 ± 0.5 and 2.9 ± 0.7, respectively. The technical success rate was 100% and the radiation dose was 272 ± 116 mGy. Thirty-six nodules (50.7%) were diagnosed as malignant, 25 (35.2%) as benign and 10 (14.1%) as indeterminate. Diagnostic accuracy, sensitivity, specificity and incidence of complications were 98.4%, 97%, 100% and 38%, respectively. Complications included pneumothorax in 18 patients (25.4%), haemoptysis in 10 (14.1%) and chest pain in one (1.4%).

Conclusion

Under CBCT guidance, PCNB of lung nodules can be performed accurately, providing both real-time fluoroscopic guidance and CT imaging capabilities.

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Acknowledgments

This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A070001).

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea

    Chang Min Park

  2. Department of Radiology, Seoul National University College of Medicine, Seoul, Korea

    Kwang Nam Jin, Chang Min Park, Jin Mo Goo, Hyun Ju Lee, Youkyung Lee, Jung Im Kim, So Young Choi & Hyo-Cheol Kim

  3. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea

    Kwang Nam Jin, Chang Min Park, Jin Mo Goo, Hyun Ju Lee, Youkyung Lee, Jung Im Kim, So Young Choi & Hyo-Cheol Kim

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  1. Kwang Nam Jin
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Correspondence to Chang Min Park.

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Jin, K.N., Park, C.M., Goo, J.M. et al. Initial experience of percutaneous transthoracic needle biopsy of lung nodules using C-arm cone-beam CT systems. Eur Radiol 20, 2108–2115 (2010). https://doi.org/10.1007/s00330-010-1783-x

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  • DOI: https://doi.org/10.1007/s00330-010-1783-x

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