title: Initial experience of percutaneous transthoracic needle biopsy of lung nodules using C-arm cone-beam CT systems.
abstract: OBJECTIVE
  To describe our initial experience with percutaneous transthoracic biopsy (PCNB) of lung nodules using C-arm cone-beam CT (CBCT).
  
  
  METHODS
  Seventy-one consecutive patients with lung nodules of 30 mm or smaller underwent CBCT-guided PCNB using a coaxial cutting needle. We evaluated the procedure time, coaxial introducer dwell time, the numbers of pleural passages, coaxial introducer repositionings and CT acquisitions, as well as the technical success rate and radiation doses. Diagnostic accuracy, sensitivity, specificity and incidence of complications were also evaluated.
  
  
  RESULTS
  PCNB was performed for 71 nodules: 63 solid, 6 part-solid and 2 ground-glass nodules. The procedure time, coaxial introducer dwell time, numbers of pleural passages, coaxial introducer repositionings and CT acquisitions were 17.9+/-5.9 min, 8.7+/-3.8 min, 1.1+/-0.4, 0.2+/-0.5 and 2.9+/-0.7, respectively. The technical success rate was 100% and the radiation dose was 272+/-116 mGy. Thirty-six nodules (50.7%) were diagnosed as malignant, 25 (35.2%) as benign and 10 (14.1%) as indeterminate. Diagnostic accuracy, sensitivity, specificity and incidence of complications were 98.4%, 97%, 100% and 38%, respectively. Complications included pneumothorax in 18 patients (25.4%), haemoptysis in 10 (14.1%) and chest pain in one (1.4%).
  
  
  CONCLUSIONS
  Under CBCT guidance, PCNB of lung nodules can be performed accurately, providing both real-time fluoroscopic guidance and CT imaging capabilities.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kwang Nam
authors.initials: KN
authors.lastname: Jin
authors.forename: Chang Min
authors.initials: CM
authors.lastname: Park
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Goo
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Lee
authors.forename: Youkyung
authors.initials: Y
authors.lastname: Lee
authors.forename: Jung Im
authors.initials: JI
authors.lastname: Kim
authors.forename: So Young
authors.initials: SY
authors.lastname: Choi
authors.forename: Hyo-Cheol
authors.initials: HC
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015641:Radiography, Interventional / Q000379:methods*; D013902:Radiography, Thoracic / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*; D013909:Thorax / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*
references.citation: Radiology. 1998 Aug;208(2):303-18
references.pmid: 9680552
references.citation: Cardiovasc Intervent Radiol. 2006 Nov-Dec;29(6):1034-8
references.pmid: 16988877
references.citation: Laryngoscope. 2005 Dec;115(12):2138-43
references.pmid: 16369157
references.citation: Radiol Clin North Am. 2000 Mar;38(2):267-79
references.pmid: 10765389
references.citation: Radiology. 2005 Feb;234(2):631-7
references.pmid: 15673500
references.citation: Radiology. 1996 Nov;201(2):576-8
references.pmid: 8888264
references.citation: J Vasc Interv Radiol. 2008 Jun;19(6):799-813
references.pmid: 18503893
references.citation: Skeletal Radiol. 2008 Dec;37(12):1069-76
references.pmid: 18443787
references.citation: J Vasc Interv Radiol. 2009 Jul;20(7):888-95
references.pmid: 19481471
references.citation: Chest. 1988 Apr;93(4):742-5
references.pmid: 3349829
references.citation: Chest. 2007 Sep;132(3 Suppl):131S-148S
references.pmid: 17873165
references.citation: Radiology. 1999 May;211(2):309-15
references.pmid: 10228508
references.citation: Radiology. 2001 Feb;218(2):491-6
references.pmid: 11161167
references.citation: AJR Am J Roentgenol. 2000 Jul;175(1):239-43
references.pmid: 10882279
references.citation: Radiology. 2001 May;219(2):515-20
references.pmid: 11323481
references.citation: AJR Am J Roentgenol. 2003 Jun;180(6):1665-9
references.pmid: 12760939
references.citation: J Vasc Interv Radiol. 1998 Mar-Apr;9(2):347-52
references.pmid: 9540921
references.citation: AJNR Am J Neuroradiol. 2009 Jun;30(6):1088-95
references.pmid: 19439484
references.citation: Clin Radiol. 2000 Apr;55(4):281-7
references.pmid: 10767187
references.citation: Dent Clin North Am. 2008 Oct;52(4):707-30, v
references.pmid: 18805225
references.citation: Radiology. 1996 Feb;198(2):371-5
references.pmid: 8596834
references.citation: Chest. 2004 Sep;126(3):748-54
references.pmid: 15364752
references.citation: Radiology. 2005 Nov;237(2):701-8
references.pmid: 16244278
references.citation: Radiographics. 2008 Nov-Dec;28(7):2009-22
references.pmid: 19001655
references.citation: Radiology. 2003 Nov;229(2):475-81
references.pmid: 14595149