title: Ultrasound Versus Computed Tomographic Guidance for Percutaneous Biopsy of Chest Lesions.
abstract: OBJECTIVE
  To compare ultrasound (US) versus computed tomography (CT) for primary guidance during needle biopsy of chest lesions.
  
  
  METHODS
  Institutional Review Board approval was obtained for this Health Insurance Portability and Accountability Act-compliant retrospective study, and the need for informed consent was waived. All US- and CT-guided chest biopsy procedures performed between January 1, 2012, and October 15, 2014, at our institution were reviewed, and all procedures targeting peripheral intrathoracic and chest wall lesions were included. Axillary lesions, lung lesions without peripheral pleural contact, and mediastinal lesions without a transcutaneous US window were excluded. Radiologic, pathologic, and clinical records were reviewed.
  
  
  RESULTS
  Fifty-five procedures with primary US guidance (23 lung, 6 pleural, 2 mediastinal, and 24 chest wall) and 130 CT procedures (88 lung, 10 pleural, 7 mediastinal, and 25 chest wall) were performed. Diagnostic samples were obtained in 98% (54 of 55) of US procedures and 87% (113 of 130) of CT procedures (P = .02). Pneumothorax requiring treatment occurred in 2% (1 of 55) of US procedures and 5% (7 of 130) of CT procedures (P = .25). Computed tomographic localization was used in 29% (16 of 55) of US procedures. Nevertheless, the average patient radiation dose was significantly less in US procedures (182 mGy-cm) versus CT procedures (718 mGy-cm; P< .01). The average procedure time was 40 minutes for US and 38 minutes for CT (P = .39). The average lesion size was 4.5 cm for US and 4.9 cm for CT (P = .14).
  
  
  CONCLUSIONS
  During biopsy of peripheral intrathoracic lesions and chest wall lesions, primary US guidance resulted in a higher likelihood of a diagnostic sample and a decreased patient radiation dose compared with CT guidance.
authors.affiliation: Department of Radiological Sciences, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma USA.
authors.forename: Maha
authors.initials: M
authors.lastname: Jarmakani
authors.affiliation: Department of Radiological Sciences, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Duguay
authors.affiliation: Department of Radiological Sciences, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma USA.
authors.forename: Kermit
authors.initials: K
authors.lastname: Rust
authors.affiliation: Department of Radiological Sciences, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma USA.
authors.forename: Keri
authors.initials: K
authors.lastname: Conner
authors.affiliation: Department of Radiological Sciences, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma USA jason-wagner@ouhsc.edu.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Wagner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D013899:Thoracic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional; D055815:Young Adult
keywords: biopsy; computed tomographic guidance; general and abdominal ultrasound; lung; needle; thoracic; ultrasound guidance