title: Cone-Beam Computed Tomography (CBCT) Versus CT in Lung Ablation Procedure: Which is Faster?
abstract: OBJECTIVE
  To compare cone-beam CT (CBCT) versus computed tomography (CT) guidance in terms of time needed to target and place the radiofrequency ablation (RFA) electrode on lung tumours.
  
  
  METHODS
  Patients at our institution who received CBCT- or CT-guided RFA for primary or metastatic lung tumours were retrospectively included. Time required to target and place the RFA electrode within the lesion was registered and compared across the two groups. Lesions were stratified into three groups according to their size (<10, 10-20, >20 mm). Occurrences of electrode repositioning, repositioning time, RFA complications, and local recurrence after RFA were also reported.
  
  
  RESULTS
  Forty tumours (22 under CT, 18 under CBCT guidance) were treated in 27 patients (19 male, 8 female, median age 67.25 ± 9.13 years). Thirty RFA sessions (16 under CBCT and 14 under CT guidance) were performed. Multivariable linear regression analysis showed that CBCT was faster than CT to target and place the electrode within the tumour independently from its size (β = -9.45, t = -3.09, p = 0.004). Electrode repositioning was required in 10/22 (45.4 %) tumours under CT guidance and 5/18 (27.8 %) tumours under CBCT guidance. Pneumothoraces occurred in 6/14 (42.8 %) sessions under CT guidance and in 6/16 (37.5 %) sessions under CBCT guidance. Two recurrences were noted for tumours receiving CBCT-guided RFA (2/17, 11.7 %) and three after CT-guided RFA (3/19, 15.8 %).
  
  
  CONCLUSIONS
  CBCT with live 3D needle guidance is a useful technique for percutaneous lung ablation. Despite lesion size, CBCT allows faster lung RFA than CT.
authors: Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France. r.cazzato@unicampus.it.|Department of Radiology and Diagnostic Imaging, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy. r.cazzato@unicampus.it.
authors: Roberto Luigi
authors: RL
authors: Cazzato
authors: Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France. j.battistuzzi@bordeaux.unicancer.fr.
authors: Jean-Benoit
authors: JB
authors: Battistuzzi
authors: Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France. vittoriocatena@gmail.com.
authors: Vittorio
authors: V
authors: Catena
authors: Department of Radiology and Diagnostic Imaging, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy. r.grasso@unicampus.it.
authors: Rosario Francesco
authors: RF
authors: Grasso
authors: Department of Radiology and Diagnostic Imaging, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy. b.zobel@unicampus.it.
authors: Bruno Beomonte
authors: BB
authors: Zobel
authors: Unit of Measurements and Biomedical Instrumentations, Biomedical Engineering Laboratory, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 198, 00128, Rome, Italy. e.schena@unicampus.it.
authors: Emiliano
authors: E
authors: Schena
authors: Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France. x.buy@bordeaux.unicancer.fr.
authors: Xavier
authors: X
authors: Buy
authors: Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France. j.palussiere@bordeaux.unicancer.fr.
authors: Jean
authors: J
authors: Palussiere
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation; D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000601:surgery; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Computed tomography; Cone-beam computed tomography; Lung neoplasms; Radiofrequency ablation