Department of Urology, University Medical Center Utrecht, C04.236, Postbox 85500, 3508 GA, Utrecht, The Netherlands.
Cardiovasc Intervent Radiol. 2012 Jun;35(3):680-5. doi: 10.1007/s00270-011-0237-4. Epub 2011 Aug 6.
Three-dimensional (3D) real-time fluoroscopy cone beam CT is a promising new technique for image-guided biopsy of solid tumors. We evaluated the technical feasibility, diagnostic accuracy, and complications of this technique for guidance of large-core needle biopsy in patients with suspicious renal masses.
Thirteen patients with 13 suspicious renal masses underwent large-core needle biopsy under 3D real-time fluoroscopy cone beam CT guidance. Imaging acquisition and subsequent 3D reconstruction was done by a mobile flat-panel detector (FD) C-arm system to plan the needle path. Large-core needle biopsies were taken by the interventional radiologist. Technical success, accuracy, and safety were evaluated according to the Innovation, Development, Exploration, Assessment, Long-term study (IDEAL) recommendations.
Median tumor size was 2.6 (range, 1.0-14.0) cm. In ten (77%) patients, the histological diagnosis corresponded to the imaging findings: five were malignancies, five benign lesions. Technical feasibility was 77% (10/13); in three patients biopsy results were inconclusive. The lesion size of these three patients was <2.5 cm. One patient developed a minor complication. Median follow-up was 16.0 (range, 6.4-19.8) months.
3D real-time fluoroscopy cone beam CT-guided biopsy of renal masses is feasible and safe. However, these first results suggest that diagnostic accuracy may be limited in patients with renal masses<2.5 cm.
三维（3D）实时透视锥形束 CT 是一种很有前途的新技术，可用于引导实性肿瘤的活检。我们评估了该技术引导可疑肾肿块患者进行大芯针活检的技术可行性、诊断准确性和并发症。
13 例 13 个可疑肾肿块患者在 3D 实时透视锥形束 CT 引导下行大芯针活检。通过移动平板探测器（FD）C 臂系统进行成像采集和随后的 3D 重建，以规划针道。由介入放射科医生进行大芯针活检。根据创新、发展、探索、评估、长期研究（IDEAL）建议评估技术成功率、准确性和安全性。
肿瘤中位数大小为 2.6（范围，1.0-14.0）cm。在 10 例（77%）患者中，组织学诊断与影像学发现相符：5 例为恶性肿瘤，5 例为良性病变。技术可行性为 77%（10/13）；在 3 例患者中，活检结果不确定。这 3 例患者的病变大小<2.5 cm。1 例患者出现轻微并发症。中位随访时间为 16.0（范围，6.4-19.8）个月。
3D 实时透视锥形束 CT 引导的肾肿块活检是可行和安全的。然而，这些初步结果表明，在直径<2.5 cm 的肾肿块患者中，诊断准确性可能有限。
