使用 3D 折线来改进锥形束 CT 引导的经皮经胸穿刺活检。
Using 3D polylines to improve cone-beam CT-guided percutaneous transthoracic needle biopsy.
机构信息
Departments of Radiology, College of Medicine, Jeonbuk National University, Jeollabuk-do, South Korea.
Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeollabuk-do, South Korea.
出版信息
Br J Radiol. 2022 Dec 1;95(1140):20220406. doi: 10.1259/bjr.20220406. Epub 2022 Nov 8.
OBJECTIVES
To investigate the diagnostic accuracy of using 3D polylines (3DPs) to improve cone-beam CT (CBCT) virtual navigation (VN)-guided percutaneous transthoracic needle biopsies (PTNB) of pulmonary lesions.
METHODS
From May 2021 to November 2021, patients (81 males and 41 females; age, 65 ± 12 years) who underwent CBCT VN with 3DPs for PTNB of pulmonary lesions were retrospectively reviewed. Fluoroscopic visibility of target lesions was evaluated using captured images from a Bull's eye view. Diagnostic accuracy was calculated, and complications were assessed.
RESULTS
The mean size of biopsied lesions was 23 ± 13 mm (range: 6-75 mm). Overall, 13.9% (17/122) were small pulmonary nodules (diameter ≤1 cm), and 68.0% (83/122) of biopsied lesions were fluoroscopic visible. The overall diagnostic accuracy was 94.3%. The diagnostic accuracy for visible and invisible lesions was 94.0 and 94.9%, respectively ( = 0.843), and 100% for small pulmonary nodules. Major complications occurred in 8.2% (10/122; eight pneumothorax with chest tube insertion, one hemoptysis with transfusion, and one air embolism) of patients.
CONCLUSION
CBCT VN with 3DP guidance provide a real-time outline of pulmonary lesions, thus enabling a reliable and accurate PTNB.
ADVANCES IN KNOWLEDGE
3DP guidance could be useful technique for CBCT-guided PTNB, especially in small pulmonary nodules.
目的
研究使用 3D 多段线（3DP）改善锥形束 CT（CBCT）虚拟导航（VN）引导经皮经胸穿刺活检（PTNB）肺部病变的诊断准确性。
方法
回顾性分析 2021 年 5 月至 2021 年 11 月期间，81 名男性和 41 名女性患者（年龄 65 ± 12 岁）接受 CBCT VN 联合 3DP 进行 PTNB 肺部病变。使用 Bull's eye 视图捕获的图像评估目标病变的透视可见性。计算诊断准确性，并评估并发症。
结果
活检病变的平均大小为 23 ± 13mm（范围：6-75mm）。总体而言，13.9%（17/122）为小肺结节（直径≤1cm），68.0%（83/122）的活检病变可透视。整体诊断准确性为 94.3%。可见和不可见病变的诊断准确性分别为 94.0%和 94.9%（=0.843），小肺结节的诊断准确性为 100%。8.2%（10/122）的患者发生主要并发症（八例气胸需胸腔引流，一例咯血需输血，一例空气栓塞）。
结论
CBCT VN 联合 3DP 引导可提供实时的肺部病变轮廓，从而实现可靠和准确的 PTNB。
知识进展
3DP 引导可能是 CBCT 引导 PTNB 的有用技术，尤其是在小肺结节中。
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