title: Flat detector C-arm CT-guided transthoracic needle biopsy of small (≤2.0 cm) pulmonary nodules: diagnostic accuracy and complication in 100 patients.
abstract: OBJECTIVE
  This study aimed at assessing the usefulness of flat detector cone-beam CT virtual navigation-guided transthoracic needle biopsy of small (≤2.0 cm) pulmonary nodules in terms of diagnostic accuracy and complications to evaluate the diagnostic performance and complications of small pulmonary nodules under cone-beam CT (CBCT) guidance.
  
  
  METHODS
  A total of 100 patients with 100 solid lung nodules were retrospectively enrolled to undergo transthoracic needle biopsy (TNB) procedures. The mean diameter of lesions was 1.25 cm ± 0.39 (range 0.50-2.00 cm). The needle path was carefully planned and calculated on the CBCT virtual navigation guidance system, which acquired 3D CT-like cross-sectional images. Diagnostic performance, complication rate, and patient radiation exposure were investigated.
  
  
  RESULTS
  The technical success rate of TNB under iGuide CBCT virtual navigation system was 99% (99/100). The sensitivity, specificity, and accuracy of TNB of small nodules under iGuide CBCT virtual navigation guidance were 98.7% (77/78), 90.5% (19/21), and 97.0% (96/99), respectively. The number of pleural passages with coaxial needle, biopsies, and CBCT acquisitions were 1.09 ± 0.32, 1.20 ± 0.47, and 3.06 ± 1.35, respectively. Complications occurred in 22 (22%) cases. The mean total procedure time was 12.84 min ± 3.74, resulting in a mean exposure dose of 7.6 mSv ±3.1.
  
  
  CONCLUSIONS
  Flat detector Cone-beam CT-guided TNB is a highly accurate and safe diagnostic method for small (≤2.0 cm) lung nodule.
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China.
authors.forename: Dechao
authors.initials: D
authors.lastname: Jiao
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China.
authors.forename: Huifeng
authors.initials: H
authors.lastname: Yuan
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China.
authors.forename: Quanhui
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China. 13592583911@163.com.
authors.forename: Xinwei
authors.initials: X
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Biopsy; Computer applications-3D; Interventional; Lung