title: C-arm cone-beam computed tomography needle path overlay for percutaneous biopsy of pulmonary nodules.
abstract: OBJECTIVE
  The aim of this study was to evaluate the feasibility of percutaneous transthoracic needle biopsy of pulmonary nodules under cone-beam computed tomography (CBCT) with "XperGuide" navigation guidance.
  
  
  METHODS
  From February 2010 to January 2012, 100 patients (63 men and 37 women; mean age 67.27 years; range 21-88 years) with 100 lung nodules (44 ≤ 3 cm, 56 > 3 cm) underwent CBCT-XperGuide guided percutaneous transthoracic needle biopsies. Technical success, diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and complications were evaluated.
  
  
  RESULTS
  Of 100 nodules (mean size 5.19 cm), 68 were diagnosed as malignant, 27 as benign, and five as indeterminate. Technical success was 95 %. Only 33 of 100 patients underwent surgery: the final pathological diagnosis was concordant with the biopsy diagnosis in 26 cases and discordant in 7 cases (false negatives). Accuracy, sensitivity, specificity, PPV and NPV were 92.6, 90.9, 100, 100 and 72 %, respectively.
  
  
  CONCLUSIONS
  CBCT-XperGuide navigation is a new, accurate and safe imaging guidance for percutaneous lung biopsies.
authors.affiliation: Interventional Radiology, University of Insubria, Varese, Italy, chiara.floridi@gmail.com.
authors.forename: Chiara
authors.initials: C
authors.lastname: Floridi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Muollo
authors.forename: Federico
authors.initials: F
authors.lastname: Fontana
authors.forename: Nicola
authors.initials: N
authors.lastname: Rotolo
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Ierardi
authors.forename: Ejona
authors.initials: E
authors.lastname: Duka
authors.forename: Carlo
authors.initials: C
authors.lastname: Pellegrino
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Carrafiello
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D054893:Cone-Beam Computed Tomography; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D008297:Male; D008875:Middle Aged; D003074:Solitary Pulmonary Nodule / Q000473:pathology*; D055815:Young Adult