Department of Medicine, McMaster University, Hamilton, ON, Canada.
St Joseph's Healthcare, Faculty of Health Science, McMaster University, Hamilton, ON, Canada.
Clin Radiol. 2014 Jul;69(7):709-14. doi: 10.1016/j.crad.2014.02.006. Epub 2014 Apr 4.
To prospectively determine efficacy and complication rates following an ultra-low dose (ULD) protocol for computed tomography (CT)-guided percutaneous needle biopsy (PNB) of lung lesions.
The use of an ULD protocol (100 kV, 7.5 mAs) for CT-guided lung biopsy was initiated, as a quality assurance initiative. All patients who underwent lung lesion biopsies under ULD were evaluated prospectively. For the purposes of comparison, a retrospective review was conducted to obtain data from patients who underwent the standard-dose protocol for CT-guided PNB of lung lesions. Total dose received, length of procedure, technical success, and complications were evaluated.
The overall technical success rate using the ULD protocol was 95.8%. There was a statistically significant 57.5% reduction in radiation dose in the ULD group. There was no significant difference in average length of procedure between the two groups. Complication rates between the two groups were comparable, with 42% in the standard-dose group and 32% in the ULD group; no major complications occurred. Within the ULD group, smaller sized lesions were found to be correlated with higher complication rates, but lesion size had no effect on the total dose of radiation received.
Radiation dose to the chest during CT-guided lung PNB is reduced significantly by 57.5% through the use of an ULD protocol. Reducing the CT radiation dose does not negatively impact patient safety or biopsy diagnostic rates in PNB.
前瞻性确定超低剂量（ULD）方案在 CT 引导下经皮肺穿刺活检（PNB）治疗肺部病变的疗效和并发症发生率。
作为一项质量保证措施，开始采用 ULD 方案（100kV，7.5mAs）进行 CT 引导下的肺活检。对所有接受 ULD 下肺病变活检的患者进行前瞻性评估。为了进行比较，对接受 CT 引导下 PNB 标准剂量方案治疗的患者进行了回顾性回顾，以获取数据。评估了总剂量、手术时间、技术成功率和并发症。
ULD 方案的总体技术成功率为 95.8%。ULD 组的辐射剂量降低了 57.5%，具有统计学意义。两组的平均手术时间无显著差异。两组的并发症发生率相似，标准剂量组为 42%，ULD 组为 32%；没有发生重大并发症。在 ULD 组中，较小的病变与较高的并发症发生率相关，但病变大小对接受的总辐射剂量没有影响。
通过使用 ULD 方案，CT 引导下肺 PNB 时胸部的辐射剂量可显著降低 57.5%。降低 CT 辐射剂量不会对 PNB 中的患者安全性或活检诊断率产生负面影响。
