Navigated liver biopsy using a novel soft tissue navigation system versus CT-guided liver biopsy in a porcine model: a prospective randomized trial.
OBJECTIVE
The aim of this prospective, randomized animal study was to compare a new computer guided needle-based navigation system for liver biopsy with conventional computed tomography (CT)-guided liver biopsy. Computer-navigated interventions provide continuous needle tracking during motion and deformation from patient respiration and movement.


METHODS
Twenty artificial tumors of about 5 mm in diameter were injected into the livers of five pigs, each at a different site. Each tumor was targeted by conventional CT-guided and computer navigated intervention. Intervention was considered complete after successful tumor biopsy. Data on procedure time, number of CT scans performed, accuracy, and success rate were recorded.


RESULTS
All tumors (100%) were biopsied successfully. Mean procedural time was comparable between the two techniques (20 ± 9 minutes conventional versus 20 ± 8 minutes navigation). Mean number of CT scans were 1.2 ± 0.4 with navigation and 6.1 ± 3.8 with the conventional technique (P < .01). The dose-length product in the conventional group was significantly higher (212 ± 116 mGy × cm) than in the navigated group (78 ± 22 mGy × cm; P < .001). Mean number of capsule penetrations was 4 ± 1 with navigation versus 2 ± 1 with the conventional technique (P < .001).


CONCLUSIONS
Computer-navigated liver biopsy may provide a promising and innovative device for easy, rapid, and successful liver biopsies with low morbidity. Further technical improvements and clinical studies in humans are required.
Müller
Sascha A
SA
Department of General, Visceral and Transplant Surgery, D - 69120, University of Heidelberg, Germany.
Maier-Hein
Lena
L
Tekbas
Aysun
A
Seitel
Alexander
A
Ramsauer
Stefanie
S
Radeleff
Boris
B
Franz
Alfred M
AM
Tetzlaff
Ralf
R
Mehrabi
Arianeb
A
Wolf
Ivo
I
Kauczor
Hans-Ulrich
HU
Meinzer
Hans-Peter
HP
Schmied
Bruno M
BM
D000818:Animals; D001706:Biopsy / Q000379:methods*; D001707:Biopsy, Needle / Q000379:methods*; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D015641:Radiography, Interventional / Q000379:methods*; D013552:Swine; D014057:Tomography, X-Ray Computed / Q000379:methods*