Comparison of cone-beam CT-guided and CT fluoroscopy-guided transthoracic needle biopsy of lung nodules

Rotolo, Nicola; Floridi, Chiara; Imperatori, Andrea; Fontana, Federico; Ierardi, Anna Maria; Mangini, Monica; Arlant, Veronica; Marchi, Giuseppe De; Novario, Raffaele; Dominioni, Lorenzo; Fugazzola, Carlo

doi:10.1007/s00330-015-3861-6

Cited by 53 publications

(48 citation statements)

References 33 publications

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“…Of these, 7 were excluded because the subjects enrolled in these studies originated from the same institution or medical center [22–28]; 3 were excluded because of insufficient data to construct 2×2 tables of TP, FP, FN, and TN [29–31]. As a result, only 8 articles [14–21] were included in this meta-analysis, having met the inclusion criteria. Figure 1 shows a detailed flowchart of study selection and the results of this systematic review and meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Seven of the studies [14,16–21] were retrospective whereas one study [15] was prospective. Of these, 4 studies [14,16–28] were conducted in different medical institutions in South Korea, whereas the other 4 studies [15,19–21] were conducted in different institutions all over the world. Information about the technical statements of PTNB using CBCT and other basic descriptions of the 8 articles involved in this systematic review and meta-analysis are listed in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…From our data extraction, it was revealed that an effective dose for CBCT-guided PTNB had been reported in all of the studies [14,15,17–21] except for the study conducted by Lee et al [16]. The reported mean estimated effective patient radiation dose ranged between 4.6–14.3 mSv (mean, 7.34 mSv) [14,18–21]. In the study by Jin et al [22], radiation dose was estimated at 272±116 mGy (range: 36–528 mGy).…”

Section: Discussionmentioning

confidence: 99%

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A Systematic Review and Meta-Analysis of C-Arm Cone-Beam CT-Guided Percutaneous Transthoracic Needle Biopsy of Lung Nodules

et al. 2018

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SummaryBackgroundA systematic review and meta-analysis of all available publications was performed to evaluate the diagnostic accuracy of percutaneous transthoracic needle biopsy (PTNB) using a C-Arm Cone-Beam CT (CBCT) system in patients with lung nodules.Material/MethodsThedatabases of PUBMED, OVID, EBSCO, EMBASE, and China National Knowledge Infrastructure (CNKI) were systematically searched for relevant original articles on the diagnostic accuracy of CBCT-guided PTNB for the diagnosis of nodules in the lungs. Diagnostic indices including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and diagnostic score (DS) were calculated. Moreover,summary receiver operating characteristic curves (SROC) were constructed with Stata (version 13.0), Rev Man (version 5.3), and Meta-disc (version 1.4) software. Other clinical indices such as incidence of complications were also recorded.ResultsEight studies met the inclusion and exclusion criteria for the meta-analysis. The pooled sensitivity, specificity, PLR, NLR, DOR, DS, and SROC with 95% confidence intervals were 0.96 (0.93–0.98), 1.00 (0.91–1.00), 711.15 (9.48–53325.89), 0.04 (0.02–0.07), 16585.29 (284.88–9.7e+05), 9.72 (5.65–13.78), and 0.99 (0.97–0.99), respectively. The incidence of pneumothorax and hemorrhage was 10–29.27% and 1.22–47.25%, respectively.ConclusionsCBCT-guided PTNB has an acceptable rate of complications and is associated with a reasonable radiation exposure. Moreover, it is a highly accurate and safe technique for the diagnosis of lung nodules and can be recommended to be used in routine clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Systematic Review and Meta-Analysis of C-Arm Cone-Beam CT-Guided Percutaneous Transthoracic Needle Biopsy of Lung Nodules

et al. 2018

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“…After the procedure, the patient has bed rest and avoid vigorous physical activity for the first 24 hours. The most frequently reported complications include: (I) Pneumothorax (5,(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59): pneumothorax is the most common complication. A small pneumothorax may spontaneously resolve without any treatment.…”

Section: Complicationsmentioning

confidence: 99%

“…A small pneumothorax may spontaneously resolve without any treatment. Conversely, patients with large pneumothoraces greater than 30% of the lung volume on chest X-ray or becomes symptomatic should have a chest tube inserted; (II) Hemorrhage (46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62): localized hematoma in lungs may resolve without treatment. In a similar manner no special treatment is required if small amount of hemoptysis (e.g., phlegm with blood) occurs.…”

Section: Complicationsmentioning

confidence: 99%

The Society for Translational Medicine: indications and methods of percutaneous transthoracic needle biopsy for diagnosis of lung cancer

Dong¹,

He²,

Liu³

et al. 2018

J. Thorac. Dis

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Development of an abdominal phantom for the validation of an oligometastatic disease diagnosis workflow

et al. 2022

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Purpose The liver is a common site for metastatic disease, which is a challenging and life‐threatening condition with a grim prognosis and outcome. We propose a standardized workflow for the diagnosis of oligometastatic disease (OMD), as a gold standard workflow has not been established yet. The envisioned workflow comprises the acquisition of a multimodal image data set, novel image processing techniques, and cone beam computed tomography (CBCT)‐guided biopsy for subsequent molecular subtyping. By combining morphological, molecular, and functional information about the tumor, a patient‐specific treatment planning is possible. We designed and manufactured an abdominal liver phantom that we used to demonstrate multimodal image acquisition, image processing, and biopsy of the OMD diagnosis workflow. Methods The anthropomorphic abdominal phantom contains a rib cage, a portal vein, lungs, a liver with six lesions, and a hepatic vessel tree. This phantom incorporates three different lesion types with varying visibility under computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography CT (PET‐CT), which reflects clinical reality. The phantom is puncturable and the size of the corpus and the organs is comparable to those of a real human abdomen. By using several modern additive manufacturing techniques, the manufacturing process is reproducible and allows to incorporate patient‐specific anatomies. As a first step of the OMD diagnosis workflow, a preinterventional CT, MRI, and PET‐CT data set of the phantom was acquired. The image information was fused using image registration and organ information was extracted via image segmentation. A CBCT‐guided needle puncture experiment was performed, where all six liver lesions were punctured with coaxial biopsy needles. Results Qualitative observation of the image data and quantitative evaluation using contrast‐to‐noise ratio (CNR) confirms that one lesion type is visible only in MRI and not CT. The other two lesion types are visible in CT and MRI. The CBCT‐guided needle placement was performed for all six lesions, including those visible only in MRI and not CBCT. This was possible by successfully merging multimodal preinterventional image data. Lungs, bones, and liver vessels serve as realistic inhibitions during needle path planning. Conclusions We have developed a reusable abdominal phantom that has been used to validate a standardized OMD diagnosis workflow. Utilizing the phantom, we have been able to show that a multimodal imaging pipeline is advantageous for a comprehensive detection of liver lesions. In a CBCT‐guided needle placement experiment we have punctured lesions that are invisible in CBCT using registered preinterventional MRI scans for needle path planning.

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Comparison of cone-beam CT-guided and CT fluoroscopy-guided transthoracic needle biopsy of lung nodules

Cited by 53 publications

References 33 publications

A Systematic Review and Meta-Analysis of C-Arm Cone-Beam CT-Guided Percutaneous Transthoracic Needle Biopsy of Lung Nodules

A Systematic Review and Meta-Analysis of C-Arm Cone-Beam CT-Guided Percutaneous Transthoracic Needle Biopsy of Lung Nodules

The Society for Translational Medicine: indications and methods of percutaneous transthoracic needle biopsy for diagnosis of lung cancer

Development of an abdominal phantom for the validation of an oligometastatic disease diagnosis workflow

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