Abstract:
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Purpose: To report our clinical experience with out of plane CT guided biopsies using the UltraGuideTM magnetic-field based navigation system.
Methods and Materials: Between February 2002 and March 2003, 20 patients with a mean age of 57 yrs (range 41-76 yrs) underwent CT guided biopsy in which an adjunct magnetic-field based navigation system was used to aid an out of plane biopsy approach. Eighteen patients had an underlying primary malignancy. All biopsies involved the use of a co-axial needle system where an outer 18 g guide needle was inserted to the lesion using the navigation system and an inner 22 g needle was then used to obtain fine needle aspirates (FNA). Immediate cytopathologic evaluation of FNA samples was available in all patients. Core samples were obtained in 3 procedures when FNA was inconclusive. Technical success was defined by CT documentation of the guide needle tip within the the target lesion.
Results: Target lesions were located in the adrenal gland (n=7), liver (n=6), pancreas (n=3), lung (n=2), retroperitoneal lymph node (n=1), and pelvis (n=1). The mean lesion size (maximum transverse diameter) was 26.5 mm (range 8-70 mm) and the mean and median cranial-caudal distance, between the transaxial planes of the final needle tip location and the needle insertion site, was 40 mm (range 18-90 mm). Needle tip positioning was successfully placed within the the lesion in all 20 biopsies. A diagnosis of malignancy was obtained in 15 biopsies. Benign diagnoses were encountered in the remaining 5 biopsies and included benign adrenal gland (n=2), fibroelastic tissue (n=1), hepocytes with steatosis (n=1) and reactive hepatocytes (n=1). No complications were encountered.
Conclusion: The UltraGuideTM navigation system is an effective adjunct tool for accurate and safe biopsy of lesions that require an out of plane approach.
Questions about this event email: mwallace@mdanderson.org
Wallace MD, M,
Out of plane CT guided biopsies using a magnetic-field based navigation system. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3102831.html
