C-Arm Cone-Beam CT Virtual Navigation-Guided Percutaneous Mediastinal Mass Biopsy: Diagnostic Accuracy and Complications.
OBJECTIVE
To assess the usefulness of C-arm cone-beam computed tomography (CBCT) virtual navigation-guided percutaneous mediastinal mass biopsy in terms of diagnostic accuracy and complication rates.


METHODS
Seventy-eight CBCT virtual navigation-guided percutaneous mediastinal mass biopsies were performed in 75 patients (M:F, 38:37; mean age, 48.55 ± 18.76 years). The procedural details, diagnostic sensitivity, specificity, accuracy and complication rate were investigated.


RESULTS
Mean lesion size was 6.80 ± 3.08 cm, skin-to-target distance was 3.67 ± 1.80 cm, core needle biopsy rate was 96.2 % (75/78), needle indwelling time was 9.29 ± 4.34 min, total procedure time was 13.26 ± 5.29 min, number of biopsy specimens obtained was 3.13 ± 1.02, number of CBCTs performed was 3.03 ± 0.68, rate of lesion border discrimination from abutting mediastinal structures on CBCT was 26.9 % (21/78), technical success rate was 100 % (78/78), estimated effective dose was 5.33 ± 4.99 mSv, and the dose area product was 12,723.68 ± 10,665.74 mGy⋅cm(2). Among the 78 biopsies, 69 were malignant, 7 were benign and 2 were indeterminate. Diagnostic sensitivity, specificity and accuracy for the diagnosis of malignancies were 97.1 % (67/69), 100 % (7/7) and 97.4 % (74/76), respectively, with a complication rate of 3.85 % (3/78), all of which were small pneumothoraces.


CONCLUSIONS
CBCT virtual navigation-guided biopsy is a highly accurate and safe procedure for the evaluation of mediastinal lesions.


CONCLUSIONS
• CBCT virtual navigation-guided percutaneous mediastinal biopsy is highly accurate • CBCT virtual navigation-guided percutaneous mediastinal biopsy is a safe procedure • Mediastinal vascular injury can be avoided under CBCT virtual navigation guidance.
Department of Radiology, Seoul National University College of Medicine, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea.|Institute of Radiation Medicine, Seoul National University Medical Research Center, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea.|Aerospace Medical Group, Air Force Education and Training Command, Jinju, Korea.
Hyungjin
H
Kim
Department of Radiology, Seoul National University College of Medicine, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea. cmpark.morphius@gmail.com.|Institute of Radiation Medicine, Seoul National University Medical Research Center, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea. cmpark.morphius@gmail.com.|Cancer Research Institute, Seoul National University, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea. cmpark.morphius@gmail.com.
Chang Min
CM
Park
Department of Radiology, Seoul National University College of Medicine, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea.|Institute of Radiation Medicine, Seoul National University Medical Research Center, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea.
Sang Min
SM
Lee
Department of Radiology, Seoul National University College of Medicine, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea.|Institute of Radiation Medicine, Seoul National University Medical Research Center, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea.|Cancer Research Institute, Seoul National University, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea.
Jin Mo
JM
Goo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods; D007223:Infant; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008482:Mediastinum / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
Cone-beam computed tomography; Image-guided biopsy; Mediastinal mass; Respiratory system; Sensitivity and specificity