Department of Radiodiagnosis, AIIMS Patna, Phulwarisharif, Bihar, India.
Department of Pathology, AIIMS Patna, Phulwarisharif, Bihar, India.
J Xray Sci Technol. 2019;27(2):287-296. doi: 10.3233/XST-180424.
Intermittent CT fluoroscopic biopsy is a new technology, but has not been studied widely. This study aims to investigate correlation between the radiation dose and fluoroscopic CT exposure factors to establish the low dose parameters for performing percutaneous lung biopsies, as well as the relationship of the mean diameter and depth of lesions with radiation dose, procedure time, success and complication rates.
This is a retrospective study to analyse lung biopsies performed using intermittent CT fluoroscopic technique with 18 G semi-automated coaxial gun on 256 slice scanner. A total of 50 patients were included in the study. Biopsy was done in three mAs and KVp settings (30 and 70, 10 and 120, 30 and 120, respectively). The statistical data analysis was performed using SPSS Statistics software.
Pneumothorax occurred in 22 % of cases. Sampling rate was 98% but histopathological diagnosis was made in 94% cases. Mean procedure time was 30.5±11.1 minutes. Low dose protocol (30 mAs and 70 KVp) had least radiation exposure during biopsy procedure (p < 0.001) with similar success rate, complications and procedure time (p > 0.05) in comparison with high dose protocol (10 and 120, 30 and 120 mAs and KVp, respectively). Mean diameter of lesions didn't correlate with radiation dose, success rate, complications and duration of procedure (p > 0.05) while significant association was found when depth was correlated with radiation exposure during fluoroscopic biopsy, duration of procedure and complication rates (p < 0.05) while no association was found with success rates.
On third generation dual energy source CT scanner, reducing mAs and KVp to 30 and 70 during fluoroscopy biopsy can produce images whose complications and success rates are comparable to high dose CT. In general, intermittent CT fluoroscopy guided lung biopsy has good success rates with acceptable complications, while utilising less radiation dose and procedure time.
间歇性 CT 透视活检是一种新技术，但尚未得到广泛研究。本研究旨在探讨辐射剂量与透视 CT 暴露因素之间的相关性，以建立用于经皮肺活检的低剂量参数，并研究病变的平均直径和深度与辐射剂量、手术时间、成功率和并发症发生率之间的关系。
这是一项回顾性研究，分析了在 256 层扫描仪上使用间歇性 CT 透视技术和 18G 半自动同轴枪进行的肺活检。共有 50 名患者纳入本研究。活检分别在 3 个毫安和千伏（30 和 70、10 和 120、30 和 120）设置下进行。统计数据分析使用 SPSS Statistics 软件进行。
气胸发生率为 22%。采样率为 98%，但组织病理学诊断率为 94%。平均手术时间为 30.5±11.1 分钟。低剂量方案（30mA 和 70kV）在活检过程中辐射暴露最少（p<0.001），成功率、并发症和手术时间相似（p>0.05），与高剂量方案（10 和 120mA 和 kVp，30 和 120mA 和 kVp）相比。病变的平均直径与辐射剂量、成功率、并发症和手术时间无相关性（p>0.05），而与透视活检期间的辐射暴露、手术时间和并发症发生率呈显著相关（p<0.05），与成功率无相关性。
在第三代双能源 CT 扫描仪上，透视活检时将毫安和千伏值降低至 30 和 70 可以产生并发症和成功率与高剂量 CT 相当的图像。总的来说，间歇性 CT 透视引导下的肺活检成功率高，并发症可接受，同时辐射剂量和手术时间更少。
