Multidetector CT fluoroscopy and cone-beam CT-guided percutaneous transthoracic biopsy: comparison based on patient doses

Abstract

In this study, two different techniques used for image-guided percutaneous transthoracic needle biopsy have been compared in terms of patient dose: computed tomography (CT) fluoroscopy (performed on a Toshiba Aquilion 64), supplied with several multidetector CT (MDCT), and cone-beam CT (CBCT) (performed on a Philips Allura Xper FD20), supplied with a few C-arm flat-panel angiographic devices. Dose data (10 patients for each technique) have been collected, and organ doses and effective dose have been evaluated using software packages enabling to simulate real acquisition geometry and X-ray exposure. As a result, higher doses were found for MDCT compared with CBCT: the effective dose is 50% higher for MDCT; ratios between mean organ doses range between 1.2 and 1.7, except for breast (0.9) and oesophagus (3.7). Even though the observed differences are not always statistically significant, the general distribution of organ doses confirms that the MDCT-guiding technique delivers higher dose than the CBCT-guided one.

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

“…For CBCT-guided biopsies, the effective dose (expressed in mSv) was estimated from dose-area product (expressed in mGy cm 2 ), using the previously described conversion factor for the Allura Xper FD20 system (0.31 mSv Gy −1 cm −2 ) that was obtained from a separate phantom study [11].…”

“…In recent years a new, real-time needle guidance technique using C-arm cone-beam CT (hereafter CBCT) was developed that can be used to visualize under fluoroscopic guidance the needle trajectory from skin to target pulmonary lesions during interventional radiology procedures [6][7][8][9][10]. It has been suggested that the CBCT system, compared to fluoro-CT, facilitates the needle biopsy procedure and likely reduces radiation exposure of patient and operator [11][12][13][14][15]; however a direct comparison with evaluation of the advantages of CBCT over conventional fluoro-CT biopsy is not currently available [15]. In this study we aimed to compare the performance of CBCT-guided and fluoro-CT-guided TNB for diagnosis of malignancy of indeterminate lung nodules, and to assess the radiation exposure with the two procedures.…”

The Uro Dyna-CT Enables Three-dimensional Planned Laser-guided Complex Punctures

“…The radiation dose is naturally higher than with standard fluoroscopy. However, compared with complex punctures with standard multidetector computed tomography (MDCT), the radiation dose even might be lower in cone-beam CT-guided procedures as with the Uro Dyna-CT [13][14][15].…”

Clinical Experience with Cone-Beam CT Navigation for Tumor Ablation

“…However, CT fluoroscopy results in operator radiation as well. In addition, CBCT radiation dose to the patient is lower than conventional CT 19,20 . The radiation dose to the patient can also be reduced once operators become more familiar with the technology.…”