Hakime Antoine, Barah Ali, Deschamps Frederic, Farouil Geoffroy, Joskin Julien, Tselikas Lambros, Auperin Anne, de Baere Thierry
Department of Interventional Radiology, Institut Gustave Roussy, 114 rue Edouard Vaillant, 94800 Villejuif, France.
J Vasc Interv Radiol. 2013 Nov;24(11):1682-9. doi: 10.1016/j.jvir.2013.05.044. Epub 2013 Jul 23.
To prospectively compare electromagnetic needle tracking (EMT) and freehand ultrasound (US)-guided liver biopsies.
Among 60 consecutive US-guided liver biopsies performed by staff radiologists (senior operators) and residents (junior operators), 30 were performed freehand and 30 with EMT. Needle placement time, numbers of needle punctures and pullbacks, and subjective scores of procedure difficulty were compared by χ(2) or Student t test.
Diagnostic success rates, defined by the procurement of an adequate histopathologic specimen, were 96.6% for freehand biopsy and 100% with EMT. Needle placement time was significantly lower for EMT (mean ± standard deviation, 45.8 s ± 48.1) than for freehand procedures (143.2 s ± 122.1; P < .01). In the freehand group, needle placement times were 179.6 seconds ± 133.3 for junior operators and 106.8 seconds ± 101.3 for senior operators (P = .15). In the EMT group, needle placement times were 49.2 seconds ± 55 for junior operators and 42.5 seconds ± 41.2 for senior operators (P = .53). The number of needle pullbacks was significantly lower for senior operators (1.2 ± 0.80) compared with junior operators (2.4 ± 1.4) in the freehand group (P = .01), with no significant difference (junior, 0.47 ± 0.92; senior, 0.67 ± 0.72; P = .24) in the EMT group. The postprocedural difficulty score was lower in the EMT group (1.5 ± 0.7) than in the freehand group (2.1 ± 1.1; P = .02). Needle placement time and number of needle pullbacks were lower in the EMT group, even after taking into account tumor size and depth and operator experience.
The EMT procedure shortens needle placement time and reduces the number of needle pullbacks needed for redirection, regardless of operator experience.
前瞻性比较电磁针跟踪（EMT）和徒手超声（US）引导下的肝脏活检。
在由放射科工作人员（高级操作人员）和住院医师（初级操作人员）连续进行的60例US引导下肝脏活检中，30例采用徒手操作，30例采用EMT。通过χ(2)检验或Student t检验比较进针时间、进针和退针次数以及操作难度主观评分。
以获取足够的组织病理学标本定义的诊断成功率，徒手活检为96.6%，EMT为100%。EMT的进针时间（均值±标准差，45.8秒±48.1）显著低于徒手操作（143.2秒±122.1；P <.01）。在徒手组中，初级操作人员的进针时间为179.6秒±133.3，高级操作人员为106.8秒±101.3（P =.15）。在EMT组中，初级操作人员的进针时间为49.2秒±55，高级操作人员为42.5秒±41.2（P =.53）。徒手组中，高级操作人员的退针次数（1.2±0.80）显著低于初级操作人员（2.4±1.4）（P =.01），EMT组无显著差异（初级，0.47±0.92；高级，0.67±0.72；P =.24）。EMT组的术后难度评分（1.5±0.7）低于徒手组（2.1±1.1；P =.02）。即使考虑肿瘤大小、深度和操作人员经验后，EMT组的进针时间和退针次数仍较低。
无论操作人员经验如何，EMT操作可缩短进针时间并减少重新进针所需的退针次数。
