title: Clinical applications of the C-arm cone-beam CT-based 3D needle guidance system in performing percutaneous transthoracic needle biopsy of pulmonary lesions.
abstract: OBJECTIVE
  This study explored the value of flat detector C-arm CT-guidance system in performing percutaneous transthoracic needle biopsy (PTNB) for lung lesions in clinical practice.
  
  
  METHODS
  A total of 110 patients with solid lung lesions were enrolled to undergo PTNB procedures. The mean diameter of lesions was 4.63 cm (range, 0.6-15cm). The needle path was carefully planned and calculated on the C-arm CT system, which acquired three-dimensional CT-like cross-sectional images. The PTNB procedures were performed under needle guidance with fluoroscopic feedbacks.
  
  
  RESULTS
  Histopathologic tissue was successfully obtained from 108 patients with a puncture success rate of 98.2% (108/110). The diagnostic accuracy rate was found to be 96.3% (104/108). There was only one case of pneumothorax (0.9%) requiring therapy. The rates of mild pneumothorax and hemoptysis were low (12.0% and 6.5%, respectively). In addition, procedural time could be limited with this technique, which helped to reduce X-ray exposure.
  
  
  CONCLUSIONS
  Our study shows that C-arm CT-based needle guidance enables reliable and efficient needle positioning and progression by providing real-time intraoperative guidance.
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China; Interventional Therapy Institute of Zhengzhou University Zhengzhou, Henan, People's Republic of China. zdyfy_han@hotmail.com.
authors.forename: De Chao
authors.initials: de C
authors.lastname: Jiao
authors.forename: Teng Fei
authors.initials: TF
authors.lastname: Li
authors.forename: Xin Wei
authors.initials: XW
authors.lastname: Han
authors.forename: Gang
authors.initials: G
authors.lastname: Wu
authors.forename: Ji
authors.initials: J
authors.lastname: Ma
authors.forename: Ming Ti
authors.initials: MT
authors.lastname: Fu
authors.forename: Qi
authors.initials: Q
authors.lastname: Sun
authors.forename: Janina
authors.initials: J
authors.lastname: Beilner
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged