title: Out-of-plane computed-tomography-guided biopsy using a magnetic-field-based navigation system.
abstract: The purpose of this article is to report our clinical experience with out-of-plane computed-tomography (CT)-guided biopsies using a magnetic-field-based navigation system. Between February 2002 and March 2003, 20 patients 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 coaxial needle system in which an outer 18G guide needle was inserted to the lesion using the navigation system and an inner 22G needle was then used to obtain fine-needle aspirates. Complications and technical success were recorded. 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 lesion in all 20 biopsies. A diagnosis of malignancy was obtained in 14 biopsies. Benign diagnoses were encountered in the remaining six biopsies and included a benign adrenal gland (n = 2), fibroelastic tissue (n = 1), hepocytes with steatosis (n = 2) and reactive hepatocytes (n = 1). No complications were encountered. A magnetic-field-based navigation system is an effective adjunct tool for accurate and safe biopsy of lesions that require an out-of-plane CT approach.
authors.affiliation: Department of Diagnostic Radiology, Section of Vascular and Interventional Radiology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. mwallace@di.mdacc.tmc.edu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Wallace
authors.forename: Sanjay
authors.initials: S
authors.lastname: Gupta
authors.forename: Marshall E
authors.initials: ME
authors.lastname: Hicks
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology*; D015641:Radiography, Interventional / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed