title: Percutaneous transthoracic needle biopsy of small (≤ 1 cm) lung nodules under C-arm cone-beam CT virtual navigation guidance.
abstract: OBJECTIVE
  To describe our initial experience with percutaneous transthoracic needle biopsy (PCNB) of small (≤1 cm) lung nodules using a cone-beam computed tomography (CBCT) virtual navigation guidance system in 105 consecutive patients.
  
  
  METHODS
  One hundred and five consecutive patients (55 male, 50 female; mean age, 62 years) with 107 small (≤1 cm) lung nodules (mean size, 0.85 cm ± 0.14) underwent PCNBs under CBCT virtual-navigation guidance system and constituted our study population. Procedural details-including radiation dose, sensitivity, specificity, diagnostic accuracy and complication rates of CBCT virtual navigation guided PCNBs-were described.
  
  
  RESULTS
  The mean number of pleural passages with the coaxial needle, biopsies, CT acquisitions, total procedure time, coaxial introducer dwelling time, and estimated radiation exposure during PCNBs were 1.03 ± 0.21, 3.1 ± 0.7, 3.4 ± 1.3, 10.5 min ± 3.2 and 7.2 min ± 2.5, and 5.72 mSv ± 4.19, respectively. Sixty nodules (56.1 %) were diagnosed as malignant, 38 (35.5 %) as benign and nine (8.4 %) as indeterminate. The sensitivity, specificity, and diagnostic accuracy of CBCT virtual-navigation-guided PCNB for small (≤1 cm) nodules were 96.7 % (58/60), 100 % (38/38) and 98.0 % (96/98), respectively. Complications occurred in 13 (12.1 %) cases; pneumothorax in seven (6.5 %) and haemoptysis in six (5.6 %).
  
  
  CONCLUSIONS
  CBCT virtual-navigation-guided PCNB is a highly accurate and safe diagnostic method for small (≤1 cm) nodules.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101, Daehangno, Jongno-gu, Seoul 110-744, South Korea.
authors.forename: Ji Yung
authors.initials: JY
authors.lastname: Choo
authors.forename: Chang Min
authors.initials: CM
authors.lastname: Park
authors.forename: Nyoung Keun
authors.initials: NK
authors.lastname: Lee
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Lee
authors.forename: Hyun-Ju
authors.initials: HJ
authors.lastname: Lee
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Goo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; 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 / Q000473:pathology*