Ga Ram Kim MD, Presenter: Nothing to Disclose

Jin Hur MD, Abstract Co-Author: Nothing to Disclose

Sang Min Lee MD, Abstract Co-Author: Nothing to Disclose

Hye-Jeong Lee MD, Abstract Co-Author: Nothing to Disclose

Yoo Jin Hong, Abstract Co-Author: Nothing to Disclose

Ji Eun Nam MD, Abstract Co-Author: Nothing to Disclose

Byoung Wook Choi MD, Abstract Co-Author: Nothing to Disclose

Tae Hoon Kim MD, Abstract Co-Author: Nothing to Disclose

Kyu Ok Choe MD, Abstract Co-Author: Nothing to Disclose

To prospectively evaluate the radiation dose, procedure time, complication rate, and diagnostic accuracy for CT-guided percutaneous needle aspiration biopsy (NAB) procedures of pulmonary lesions performed with or without fluoroscopic guidance.

A total of 142 patients were prospectively enrolled to perform CT-guided NAB with (Group I, n = 72) or without (Group II, n = 70) fluoroscopic guidance. The inclusion criteria were lesion size more than 8 mm, but less than 5 cm and lesions of solid nature (ground glass opacity component of less than 50%). Outcome measurements were radiation dose to patients and doctors, total procedure time, and complication rate. Sensitivity, specificity and accuracy was calculated on the basis of 142 NAB results, and compared between the two groups using the chi-square test.

Mean estimated effective patient radiation dose was 6.53 mSv in group I and 2.72 mSv for group II, respectively (p < 0.001). Mean estimated effective doctor dose measured using TLD for whole body and hand were 0.054 mSv and 0.759 mSv in group I and 0.029 mSv and 0.034 mSv in group II, respectively (p < 0.001). The total procedure time was also significantly different between the two groups (17.16 versus 23.53 min, p < 0.001). The complication rate was significantly different between the two groups (13.4% versus 31.4%, p = 0.012). Sensitivity, specificity and accuracy for diagnosing pulmonary lesions were 88.0%, 100% and 91.7% in group I and 87.2%, 100% and 91.4% in group II, respectively (p > 0.05).

CT fluoroscopy-guided NAB of pulmonary lesions provides high diagnostic accuracy, comparable to that of conventional CT-guided NAB, and can be performed safely with a significantly shorter procedure time and a significantly lower rate of complications. However, radiation exposure to the patient and doctor was significantly higher than that of conventional CT-guided NAB.

CT fluoroscopy-guided NAB of pulmonary lesions provides high diagnostic accuracy, and is safer than conventional CT-guided NAB, although radiation exposure is higher with CT fluoroscopy-guided NAB.

Kim, G, Hur, J, Lee, S, Lee, H, Hong, Y, Nam, J, Choi, B, Kim, T, Choe, K, CT Fluoroscopy-guided Lung Biopsy versus Conventional CT-guided Lung Biopsy: Prospective Controlled Study for the Assessment of Radiation Dose and Diagnostic Performance.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9004097.html