title: Combined fluoroscopy- and CT-guided transthoracic needle biopsy using a C-arm cone-beam CT system: comparison with fluoroscopy-guided biopsy.
abstract: OBJECTIVE
  The aim of this study was to evaluate the usefulness of combined fluoroscopy- and CT-guided transthoracic needle biopsy (FC-TNB) using a cone beam CT system in comparison to fluoroscopy-guided TNB (F-TNB).
  
  
  METHODS
  We retrospectively evaluated 74 FC-TNB cases (group A) and 97 F-TNB cases (group B) to compare their respective diagnostic accuracies according to the size and depth of the lesion, as well as complications, procedure time, and radiation dose.
  
  
  RESULTS
  The sensitivity for malignancy and diagnostic accuracy for small (< 30 mm in size) and deep (≥ 50 mm in depth) lesions were higher in group A (91% and 94%, 92% and 94%) than in group B (73% and 81%, 84% and 88%), however not statistically significant (p > 0.05). Concerning lesions ≥ 30 mm in size and < 50 mm in depth, both groups displayed similar results (group A, 91% and 92%, 80% and 87%; group B, 90% and 92%, 86% and 90%). Pneumothorax occurred 26% of the time in group A and 14% for group B. The mean procedure time and patient skin dose were significantly higher in group A (13.6 ± 4.0 minutes, 157.1 ± 76.5 mGy) than in group B (9.0 ± 3.5 minutes, 21.9 ± 15.2 mGy) (p < 0.05).
  
  
  CONCLUSIONS
  Combined fluoroscopy- and CT-guided TNB allows the biopsy of small (< 30 mm) and deep lesions (≥ 50 mm) with high diagnostic accuracy and short procedure times, whereas F-TNB is still a useful method for large and superficial lesions with a low radiation dose.
authors.affiliation: Department of Radiology, School of Medicine, Ewha Womans University, Seoul 158-710, Korea.
authors.forename: Joo Yeon
authors.initials: JY
authors.lastname: Cheung
authors.forename: Yookyung
authors.initials: Y
authors.lastname: Kim
authors.forename: Sung Shine
authors.initials: SS
authors.lastname: Shim
authors.forename: Soo Mee
authors.initials: SM
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D054893:Cone-Beam Computed Tomography; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012680:Sensitivity and Specificity