Image-guided percutaneous trans-thoracic needle biopsy is a recognized, safe and accurate diagnostic technique for the evaluation of benignity or malignancy of pulmonary nodules [1;2]. However, its success is dependant on nodule characteristics and operator technique and imaging. Conventional computed tomography (CT) guidance has several limitations: radiation to the patient lack of three dimensional imaging and lack of real-time visualization unless CT fluoroscopy is used [3]. CT fluoroscopy is associated with significant operator exposure and dose not completely resolve the limitations of real time 3D image...

Patients characteristics This was a retrospective review of the biopsies performed in our institution between February 2010 to July 2011. This study was approved by internal board review of our Hospital. From February 2010 to July 2011, 70 percutaneous transthoracic needle biopsies of pulmonary nodules were performed in 70 patients (40 males, 30 females, mean age 65.6 years, range 26-82 years). All patients had a diagnostic conventional chest CT prior to biopsy. The mean size of the lesion was on average 5,5 cm (range 1...

Results Technical success rate was achieved in 100% of cases. Accuracy was 94.2%. Forty-six lesions were diagnosed as malignant, 20 were benign, and 4 were indeterminate. Only 20 of 70 nodules underwent surgical resection and the remaining 50 were followed – up with clinical and CT features. Of the 20 patients who underwent surgery, final pathological diagnosis was concordant with FNAB diagnosis in 17 cases and discordant with FNAB diagnoses in 3 cases. This discrepancy was likely caused by sampling error during fine needle aspiration...

CBCT is a technology whereby CT-like images are acquired through the use of a C-arm angiography system that rotates around the patient. In our study the diagnostic accuracy, safety of CBCT-navigation for percutaneous transthoracic lung biopsy are satisfying, similar to previous publications about this technique [8-13]. CBCT navigation, thus, offers the advantage of CT-like imaging and real-time fluoroscopy as opposed to high radiation of CT fluoroscopy. Moreover, the use of CBCT to guide percutaneous transthoracic lung biopsy could be useful in Radiology Departments allowing CT...

[1] Ohno Y, Hatabu H, Takenaka D, et al. CT-Guided Transthoracic Needle Aspiration Biopsy of Small (<= 20mm) Solitary Pulmonary Nodules. AJR. 2003; 180: 1665-1669. [2] Gupta S, Krishnamurty S, Broemeling LD, et al. Small (<= 2cm) Subleural Pulmonary Lesions: Short-Versus Long Needle Path CT Guided Biopsy Comparison of Diagnostic Yields and Complications. Radiology. 2005; 234: 631-637. [3] Frank K, Wacker BM. CT- and MR-Guided Interventions in Radiology. In: Wacker FK, Meer B (eds) Interventions using C-Arm Computed Tomography. Springer, Heidelberg, (2009) 370-381 5 [4]...

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