title: CT fluoroscopy-guided lung biopsy with novel steerable biopsy canula: ex-vivo evaluation in ventilated porcine lung explants.
abstract: The purpose was to evaluate ex-vivo a prototype of a novel biopsy canula under CT fluoroscopy-guidance in ventilated porcine lung explants in respiratory motion simulations. Using an established chest phantom for porcine lung explants, n = 24 artificial lesions consisting of a fat-wax-Lipiodol mixture (approx. 70HU) were placed adjacent to sensible structures such as aorta, pericardium, diaphragm, bronchus and pulmonary artery. A piston pump connected to a reservoir beneath a flexible silicone reconstruction of a diaphragm simulated respiratory motion by rhythmic inflation and deflation of 1.5 L water. As biopsy device an 18-gauge prototype biopsy canula with a lancet-like, helically bended cutting edge was used. The artificial lesions were punctured under CT fluoroscopy-guidance (SOMATOM Sensation 64, Siemens, Erlangen, Germany; 30mAs/120 kV/5 mm slice thickness) implementing a dedicated protocol for CT fluoroscopy-guided lung biopsy. The mean-diameter of the artificial lesions was 8.3 +/- 2.6 mm, and the mean-distance of the phantom wall to the lesions was 54.1 +/- 13.5 mm. The mean-displacement of the lesions by respiratory motion was 14.1 +/- 4.0 mm. The mean-duration of CT fluoroscopy was 9.6 +/- 5.1 s. On a 4-point scale (1 = central; 2 = peripheral; 3 = marginal; 4 = off target), the mean-targeted precision was 1.9 +/- 0.9. No misplacement of the biopsy canula affecting adjacent structures could be detected. The novel steerable biopsy canula proved to be efficient in the ex-vivo set-up. The chest phantom enabling respiratory motion and the steerable biopsy canula offer a feasible ex-vivo system for evaluating and training CT fluoroscopy-guided lung biopsy adapted to respiratory motion.
authors.affiliation: Department of Diagnostic Radiology, University Hospital Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel, Germany. jp.schaefer@rad.uni-kiel.de
authors.forename: Philipp J
authors.initials: PJ
authors.lastname: Schaefer
authors.forename: Michael
authors.initials: M
authors.lastname: Fabel
authors.forename: Hendrik
authors.initials: H
authors.lastname: Bolte
authors.forename: Fritz K W
authors.initials: FK
authors.lastname: Schaefer
authors.forename: Thomas
authors.initials: T
authors.lastname: Jahnke
authors.forename: Martin
authors.initials: M
authors.lastname: Heller
authors.forename: Johannes
authors.initials: J
authors.lastname: Lammer
authors.forename: Juergen
authors.initials: J
authors.lastname: Biederer
mesh_terms: D000818:Animals; D001706:Biopsy / Q000295:instrumentation*; D057785:Catheters; D003964:Diaphragm; D005471:Fluoroscopy / Q000379:methods; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology*; D023421:Models, Animal; D008954:Models, Biological; D019047:Phantoms, Imaging; D015656:Respiratory Mechanics; D013552:Swine; D014057:Tomography, X-Ray Computed / Q000379:methods*