title: CT fluoroscopy-guided vs. multislice CT biopsy mode-guided lung biopsies: accuracy, complications and radiation dose.
abstract: BACKGROUND
  The aim of this retrospective study was to compare the diagnostic accuracy, the frequency of complications, the duration of the interventions and the radiation doses of CT fluoroscopy (CTF) guided biopsies of lung lesions with those of multislice CT (MS-CT) biopsy mode-guided biopsies.
  
  
  METHODS
  Data and images from 124 consecutive patients undergoing CTF-guided lung biopsy (group A) and 132 MS-CT-biopsy mode-guided lung biopsy (group B) were reviewed. CTF-guided biopsies were performed on a Siemens Emotion 6 CT scanner with intermittent or continuous CT-fluoroscopy, MS-CT biopsy mode-guided biopsies were performed on a Siemens Emotion 16 CT scanner. All biopsies were performed with a coaxial needle technique.
  
  
  RESULTS
  The two groups (A vs. B) did not differ significantly regarding sensitivity (95.5% vs. 95.9%), specificity (96.7% vs. 95.5%), negative predictive value (87.9% vs. 84%) or positive predictive value (98.8% vs. 98.9%). Pneumothorax was observed in 30.0% and 32.5% of the patients, respectively. Chest tube placement was necessary in 4% (group A) and 13% (group B) of the patients. The duration of the intervention was significantly longer in group A (median 37 min vs. 32 min, p=0.04). The mean CT dose index (CTDI) was 422 in group A and 36.3 in group B (p<0.001).
  
  
  CONCLUSIONS
  Compared to CTF-guided biopsies, chest biopsies using the MS-CT biopsy mode show dramatically lower CTDI levels. Although the diagnostic yield of the procedures do not differ significantly, biopsies using the MS-CT-biopsy mode have a three-fold higher rate of chest tube placement.
authors.affiliation: Otto Wagner Hospital, Dept. of Radiology, Sanatoriumstr. 2, 1140 Vienna, Austria. helmut.prosch@meduniwien.ac.at
authors.forename: Helmut
authors.initials: H
authors.lastname: Prosch
authors.forename: Alfred
authors.initials: A
authors.lastname: Stadler
authors.forename: Matthias
authors.initials: M
authors.lastname: Schilling
authors.forename: Sandra
authors.initials: S
authors.lastname: Bürklin
authors.forename: Edith
authors.initials: E
authors.lastname: Eisenhuber
authors.forename: Ewald
authors.initials: E
authors.lastname: Schober
authors.forename: Gerhard
authors.initials: G
authors.lastname: Mostbeck
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D001706:Biopsy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D015995:Prevalence; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000706:statistics & numerical data*; D011874:Radiometry; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D055815:Young Adult