Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101, Daehangno, Jongno-gu, Seoul 110-744, South Korea.
Eur Radiol. 2013 Mar;23(3):712-9. doi: 10.1007/s00330-012-2644-6. Epub 2012 Sep 14.
To describe our initial experience with percutaneous transthoracic needle biopsy (PCNB) of small (≤1 cm) lung nodules using a cone-beam computed tomography (CBCT) virtual navigation guidance system in 105 consecutive patients.
One hundred and five consecutive patients (55 male, 50 female; mean age, 62 years) with 107 small (≤1 cm) lung nodules (mean size, 0.85 cm ± 0.14) underwent PCNBs under CBCT virtual-navigation guidance system and constituted our study population. Procedural details-including radiation dose, sensitivity, specificity, diagnostic accuracy and complication rates of CBCT virtual navigation guided PCNBs-were described.
The mean number of pleural passages with the coaxial needle, biopsies, CT acquisitions, total procedure time, coaxial introducer dwelling time, and estimated radiation exposure during PCNBs were 1.03 ± 0.21, 3.1 ± 0.7, 3.4 ± 1.3, 10.5 min ± 3.2 and 7.2 min ± 2.5, and 5.72 mSv ± 4.19, respectively. Sixty nodules (56.1 %) were diagnosed as malignant, 38 (35.5 %) as benign and nine (8.4 %) as indeterminate. The sensitivity, specificity, and diagnostic accuracy of CBCT virtual-navigation-guided PCNB for small (≤1 cm) nodules were 96.7 % (58/60), 100 % (38/38) and 98.0 % (96/98), respectively. Complications occurred in 13 (12.1 %) cases; pneumothorax in seven (6.5 %) and haemoptysis in six (5.6 %).
CBCT virtual-navigation-guided PCNB is a highly accurate and safe diagnostic method for small (≤1 cm) nodules.
描述我们在 105 例连续患者中使用锥形束 CT（CBCT）虚拟导航引导系统对小（≤1cm）肺结节进行经皮经胸穿刺活检（PCNB）的初步经验。
105 例连续患者（55 例男性，50 例女性；平均年龄 62 岁），共 107 个小（≤1cm）肺结节（平均大小 0.85cm±0.14cm），在 CBCT 虚拟导航引导系统下行 PCNB，构成我们的研究人群。描述了程序细节，包括 CBCT 虚拟导航引导 PCNB 的辐射剂量、敏感性、特异性、诊断准确性和并发症发生率。
同轴针的胸膜通道、活检、CT 采集、总手术时间、同轴引入器停留时间和 PCNB 期间的估计辐射暴露的平均值分别为 1.03±0.21、3.1±0.7、3.4±1.3、10.5min±3.2 和 7.2min±2.5，和 5.72mSv±4.19。60 个结节（56.1%）被诊断为恶性，38 个（35.5%）为良性，9 个（8.4%）为不确定。CBCT 虚拟导航引导 PCNB 对小（≤1cm）结节的敏感性、特异性和诊断准确性分别为 96.7%（58/60）、100%（38/38）和 98.0%（96/98）。并发症发生在 13 例（12.1%）病例中；7 例（6.5%）气胸和 6 例（5.6%）咯血。
CBCT 虚拟导航引导 PCNB 是一种对小（≤1cm）结节具有高度准确性和安全性的诊断方法。
