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C-Arm Cone-Beam CT Virtual Navigation-Guided Percutaneous Mediastinal Mass Biopsy: Diagnostic Accuracy and Complications.

Abstract：

OBJECTIVES:To assess the usefulness of C-arm cone-beam computed tomography (CBCT) virtual navigation-guided percutaneous mediastinal mass biopsy in terms of diagnostic accuracy and complication rates. METHODS:Seventy-eight CBCT virtual navigation-guided percutaneous mediastinal mass biopsies were performed in 75 patients (M:F, 38:37; mean age, 48.55 ± 18.76 years). The procedural details, diagnostic sensitivity, specificity, accuracy and complication rate were investigated. RESULTS:Mean lesion size was 6.80 ± 3.08 cm, skin-to-target distance was 3.67 ± 1.80 cm, core needle biopsy rate was 96.2 % (75/78), needle indwelling time was 9.29 ± 4.34 min, total procedure time was 13.26 ± 5.29 min, number of biopsy specimens obtained was 3.13 ± 1.02, number of CBCTs performed was 3.03 ± 0.68, rate of lesion border discrimination from abutting mediastinal structures on CBCT was 26.9 % (21/78), technical success rate was 100 % (78/78), estimated effective dose was 5.33 ± 4.99 mSv, and the dose area product was 12,723.68 ± 10,665.74 mGy⋅cm(2). Among the 78 biopsies, 69 were malignant, 7 were benign and 2 were indeterminate. Diagnostic sensitivity, specificity and accuracy for the diagnosis of malignancies were 97.1 % (67/69), 100 % (7/7) and 97.4 % (74/76), respectively, with a complication rate of 3.85 % (3/78), all of which were small pneumothoraces. CONCLUSIONS:CBCT virtual navigation-guided biopsy is a highly accurate and safe procedure for the evaluation of mediastinal lesions. KEY POINTS:• CBCT virtual navigation-guided percutaneous mediastinal biopsy is highly accurate • CBCT virtual navigation-guided percutaneous mediastinal biopsy is a safe procedure • Mediastinal vascular injury can be avoided under CBCT virtual navigation guidance.

journal_name

Eur Radiol

journal_title

European radiology

authors

Kim H,Park CM,Lee SM,Goo JM

doi

10.1007/s00330-015-3762-8

subject

Has Abstract

pub_date

2015-12-01 00:00:00

pages

3508-17

issue

12

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-015-3762-8

journal_volume

25

pub_type

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