C-Arm Cone-Beam CT-Guided Percutaneous Transthoracic Lung Biopsy: Usefulness in Evaluation of Small Pulmonary Nodules

Hwang, Hye Sun; Chung, Myung Jin; Lee, Ju Won; Shin, Sung Wook; Lee, Kyung Soo

doi:10.2214/ajr.09.3963

Cited by 65 publications

(65 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, this method has shown disadvantages in puncture accuracy, as well as in predicting the path and depth of puncture. Moreover, DSA has difficulty in identifying lesions smaller than 10 mm or lesions adjacent to blood vessels or the mediastinum (Hwang et al, 2010), as well as in recognizing minor complications in sufficient time.…”

Section: Discussionmentioning

confidence: 99%

“…Other researchers have studied the radiation dose of C-arm CT-guided lung biopsy. Hwang et al (2010) discovered that the average effective doses were 4.6 mSv and Jin et al (2010) showed that the cumulative dose was 271 ± 116 mGy for C-arm CTguided lung biopsy. In our research, the average cumulative dose and average effective dose for RFA were 187.62 ± 108.46 mGy and 5.50 ± 3.31 mSv, respectively.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Value of C-arm computed tomography in radiofrequency ablation of small lung lesions

Li¹,

Zhang²,

Huang³

et al. 2014

Genet. Mol. Res.

View full text Add to dashboard Cite

ABSTRACT. This study aimed to explore the value of C-arm computed tomography (CT) applications in radiofrequency ablation (RFA) of small lung lesions. The puncture success rate, cumulative survival rate, tumor response rate, complications, and radiation dose during C-arm CT-guided RFA of 36 small lung lesions in 34 patients were analyzed. In 35 RFA procedures for 36 small lung lesions, the puncture success rate was 100%. There were 7 cases of complications, including 4 cases of pneumothorax (puncture suction or closed chest drainage was not required) and 3 cases of hemoptysis. The cumulative survival rate in the 34 patients after RFA was 100% at 6 months, 69.0% at 1 year, and 60.0% at 2 years. In assessments of 36 foci imaged during the follow-up period, the total response rates at 1 month, 3 months, and 6 months were 77.8% (28/36), 69.7% (23/33), and 61.3% (19/31), respectively. The mean cumulative dose and average effective dose during surgery were 120.1 ± 61.4 mGy and 3.5 ± 1.7 mSv, respectively. The application of C-arm CT to RFA of small lung lesions could provide abundant information to the surgeon and increase the lesion puncture success rate and is considered to be a promising image-guided technology.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Value of C-arm computed tomography in radiofrequency ablation of small lung lesions

Li¹,

Zhang²,

Huang³

et al. 2014

Genet. Mol. Res.

View full text Add to dashboard Cite

show abstract

“…Braak et al [8] described the effective patient dose of CBCT guidance procedures to be reduced by 13-42% compared with CT guidance for abdominal and thoracic procedures. Other authors reported diagnostic accuracies of CBCT guidance to be comparable to or higher than other guidance modalities [14][15][16][20][21][22]. However, until now, the accuracy of CBCT guidance for reaching small (millimetre-sized) targets has not been addressed specifically.…”

mentioning

confidence: 99%

Cone beam CT guidance provides superior accuracy for complex needle paths compared with CT guidance

Busser¹,

Braak²,

Fütterer³

et al. 2013

BJR

View full text Add to dashboard Cite

Objective: To determine the accuracy of cone beam CT (CBCT) guidance and CT guidance in reaching small targets in relation to needle path complexity in a phantom. Methods: CBCT guidance combines three-dimensional CBCT imaging with fluoroscopy overlay and needle planning software to provide real-time needle guidance. The accuracy of needle positioning, quantified as deviation from a target, was assessed for inplane, angulated and double angulated needle paths. Four interventional radiologists reached four targets along the three paths using CBCT and CT guidance. Accuracies were compared between CBCT and CT for each needle path and between the three approaches within both modalities. The effect of user experience in CBCT guidance was also assessed. Results: Accuracies for CBCT were significantly better than CT for the double angulated needle path (2.2 vs 6.7 mm, p,0.001) for all radiologists. CBCT guidance showed no significant differences between the three approaches. For CT, deviations increased with increasing needle path complexity from 3.3 mm for the inplane placements to 4.4 mm (p50.007) and 6.7 mm (p,0.001) for the angulated and double angulated CT-guided needle placements, respectively. For double angulated needle paths, experienced CBCT users showed consistently higher accuracies than trained users [1.8 mm (range 1.2-2.2) vs 3.3 mm (range 2.1-7.2) deviation from target, respectively; p50.003]. Conclusion: In terms of accuracy, CBCT is the preferred modality, irrespective of the level of user experience, for more difficult guidance procedures requiring double angulated needle paths as in oncological interventions. Advances in knowledge: Accuracy of CBCT guidance has not been discussed before. CBCT guidance allows accurate needle placement irrespective of needle path complexity. For angulated and double-angulated needle paths, CBCT is more accurate than CT guidance.Needle guidance for puncture or other minimally invasive procedures is increasing in standard interventional radiology practice. In local therapy procedures, such as percutaneous ablations, accurate placement of one or more needles is important in order to provide effective treatment [1]. This is especially the case in treatment or biopsy procedures of small lesions, in which the tip of the needle needs to be placed within a range of millimetres of the target point. Therefore, image guidance plays a significant role in accurate percutaneous needle placement [2].Currently, most needle placement procedures are performed using CT guidance, fluoroscopy or ultrasound [3]. CT images provide good visualisation of the target and surrounding tissues. For needle guidance, however, CT has limitations mainly because it does not allow real-time feedback on needle progression. For semi-real-time imaging within the CT scanner, CT-fluoroscopy can be used at the expense of a higher radiation dose to the patient and operator [4]. Acquiring CT fluoroscopy images to check needle position takes approximately 1 s, time in which the needle cannot be progressed.Fluorosc...

show abstract

“…To solve the problem of pulmonary nodule positioning, most doctors still use intraoperative finger palpation. The main advantage of palpation lies in the fact that the technique is a very simple method for both doctors and patients (Hwang et al, 2010). For nodules less than 1 cm deep to the pleura and with a diameter greater than 1 cm, the method is very effective (Yin et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Preoperative computed tomography-guided hook-wire positioning of pulmonary nodules

Zhai

Guan

et al. 2015

Genet. Mol. Res.

View full text Add to dashboard Cite

ABSTRACT.This study aimed to analyze the clinical application value of computed tomography (CT)-guided hook-wire positioning before thoracoscopic surgery. Eighty-four patients who had received a thoracoscopic wedge resection of pulmonary nodules between January and December 2013 were selected. Group A consisted of 38 cases where the hook-wire positioning technique was not used, and the positioning approaches were intraoperative observation and palpation. Group B consisted of 46 cases where the hook-wire positioning technique was used. The diameter of each nodule was less than 2 cm, and all patients underwent the operation within 2 h of invasive positioning. The evaluation indexes included positioning success rate, positioningrelated complications, and rate of conversion to thoracotomy. In Group A, nine patients (23.68%) underwent conversion to thoracotomy; in Group B, three patients (6.52%) did. This difference was statistically significant (P < 0.05). The average operation duration was 118 ± 21 min in Group A and 53 ± 18 min in Group B. The difference between both groups was statistically significant (P < 0.05). The average length 3799 Positioning of pulmonary nodules ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 14 (2): 3798-3806 (2015) of hospital stay of patients who underwent conversion to thoracotomy was 8.7 ± 2.2 days, and of patients who underwent thoracoscopic pulmonary wedge resection was 4.5 ± 1.6 days. This difference was statistically significant (P < 0.05). Therefore, CT-guided hook-wire positioning of pulmonary nodules before thoracoscopic surgery has clinical application value. It helps to accurately locate the pulmonary nodules, effectively lowers the rate of conversion to thoracotomy, and reduces the operation duration.

show abstract

C-Arm Cone-Beam CT-Guided Percutaneous Transthoracic Lung Biopsy: Usefulness in Evaluation of Small Pulmonary Nodules

Abstract: C-arm cone-beam CT-guided percutaneous transthoracic lung biopsy is a useful diagnostic technique in the evaluation of small lung nodules.

Cited by 65 publications

References 34 publications

Value of C-arm computed tomography in radiofrequency ablation of small lung lesions

Value of C-arm computed tomography in radiofrequency ablation of small lung lesions

Cone beam CT guidance provides superior accuracy for complex needle paths compared with CT guidance

Preoperative computed tomography-guided hook-wire positioning of pulmonary nodules

Contact Info

Product

Resources

About