Biopsy of lung nodules with use of I-I device under intermittent CT fluoroscopic guidance: preliminary clinical study.
OBJECTIVE
To investigate the efficacy of computed tomography (CT) fluoroscopy and a new needle holder (the I-I device) in lung nodule biopsy.


METHODS
The I-I device is made of acrylate resin and was used to keep the entire needle in the tomographic plane. This study consisted of biopsies of 79 lung nodules in 77 patients. The final diagnoses were malignant in 54 patients, benign in 23, and unconfirmed in two. The biopsy procedure time from the beginning of the CT fluoroscopy procedure to the removal of the needle was measured for 24 needle passes. The radiation dose on the physician's hand was measured in five cases with use of a thermoluminescence ring.


RESULTS
Fifty-one malignant and 20 benign lesions were correctly diagnosed with histologic specimens (90%). In 58 of 77 patients (75%), the biopsy procedures were completed within a single breath-hold. Pneumothorax occurred in 20 of 77 patients (26%) and chest tube insertion was required in five. The incidence of pneumothorax was significantly lower in patients who held their breath during biopsy procedures compared with those who did not (P < .0001; chi2 test). The biopsy procedure time ranged from 15 to 39 seconds (mean: 28.2 sec). The mean radiation dose on the physician's hand was 2 mSv/case.


CONCLUSIONS
The diagnostic accuracy of biopsy with use of the I-I device under CT fluoroscopic guidance is comparable with that of the conventional method; however, a combination of CT fluoroscopy and the I-I device enables rapid biopsy procedures.
Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan. tirie@igaku.md.tsukuba.ac.jp
T
T
Irie
M
M
Kajitani
K
K
Matsueda
Y
Y
Arai
Y
Y
Inaba
Y
Y
Kujiraoka
Y
Y
Itai
D001707:Biopsy, Needle / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008168:Lung / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000453:epidemiology; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000473:pathology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed