Eui Jin Hwang1, Hyungjin Kim1, Chang Min Park1,2, Soon Ho Yoon1,2, Hyun-Ju Lim3, Jin Mo Goo1,2. 1. 1 Department of Radiology, Seoul National University College of Medicine , Seoul , Korea. 2. 2 Institute of Radiation Medicine, Seoul National University Medical Research Center , Seoul , Korea. 3. 3 Department of Radiology, National Cancer Center , Goyang-si, Gyeonggi-do , Korea.
Abstract
OBJECTIVE: To evaluate the impact of nodule visibility during real-time fluoroscopy and other biopsy-related variables on the diagnostic accuracy and complication rates of cone beam CT (CBCT) virtual navigation (VN)-guided percutaneous transthoracic needle biopsies (PTNBs) of small (≤1 cm) pulmonary nodules. METHODS: Patients (99 males and 114 females; age, 62.1 ± 11.1 years) who underwent CBCT VN-guided biopsies for lung nodules ≤ 1 cm were retrospectively reviewed. The visibility of target nodules was assessed on the captured fluoroscopy images. Diagnostic accuracies were calculated and logistic regression analyses were performed to determine independent influencing factors for the correct diagnosis and complications (pneumothoraxes and hemoptysis) in CBCT VN-guided PTNBs, respectively. RESULTS: Among 213 nodules, 63 (29.6%) were invisible on real-time fluoroscopy during VN. The diagnostic accuracy of CBCT VN-guided PTNBs for the invisible nodules was 76.7%, while for the visible nodules was 89.1% (p = 0.042). In the logistic regression analysis, the visibility of a target nodule (odds ratio = 2.49, p = 0.047) was the only independent influencing factor for a correct diagnosis. As regards complication rates, nodule visibility was not a significant factor for the occurrence of a pneumothorax or hemoptysis. CONCLUSION: Although nodule visibility on real-time fluoroscopy was an affecting factor for the correct diagnosis, CBCT VN-guided PTNB was feasible for the invisible nodules with diagnostic accuracy of 76.7%. Advance in knowledge: CBCT VN-guided PTNB can be tried safely for the subcentimeter-sized pulmonary nodules regardless of their fluoroscopic visibility.
OBJECTIVE: To evaluate the impact of nodule visibility during real-time fluoroscopy and other biopsy-related variables on the diagnostic accuracy and complication rates of cone beam CT (CBCT) virtual navigation (VN)-guided percutaneous transthoracic needle biopsies (PTNBs) of small (≤1 cm) pulmonary nodules. METHODS:Patients (99 males and 114 females; age, 62.1 ± 11.1 years) who underwent CBCT VN-guided biopsies for lung nodules ≤ 1 cm were retrospectively reviewed. The visibility of target nodules was assessed on the captured fluoroscopy images. Diagnostic accuracies were calculated and logistic regression analyses were performed to determine independent influencing factors for the correct diagnosis and complications (pneumothoraxes and hemoptysis) in CBCT VN-guided PTNBs, respectively. RESULTS: Among 213 nodules, 63 (29.6%) were invisible on real-time fluoroscopy during VN. The diagnostic accuracy of CBCT VN-guided PTNBs for the invisible nodules was 76.7%, while for the visible nodules was 89.1% (p = 0.042). In the logistic regression analysis, the visibility of a target nodule (odds ratio = 2.49, p = 0.047) was the only independent influencing factor for a correct diagnosis. As regards complication rates, nodule visibility was not a significant factor for the occurrence of a pneumothorax or hemoptysis. CONCLUSION: Although nodule visibility on real-time fluoroscopy was an affecting factor for the correct diagnosis, CBCT VN-guided PTNB was feasible for the invisible nodules with diagnostic accuracy of 76.7%. Advance in knowledge: CBCT VN-guided PTNB can be tried safely for the subcentimeter-sized pulmonary nodules regardless of their fluoroscopic visibility.
Authors: Stanley E K Loh; Donald D F Wu; Sudhakar K Venkatesh; Cheng Kang Ong; Eugene Liu; Kar Yin Seto; Anil Gopinathan; Lenny K A Tan Journal: Ann Acad Med Singapore Date: 2013-06 Impact factor: 2.473
Authors: Ji Yung Choo; Chang Min Park; Nyoung Keun Lee; Sang Min Lee; Hyun-Ju Lee; Jin Mo Goo Journal: Eur Radiol Date: 2012-09-14 Impact factor: 5.315
Authors: Claudia I Henschke; David F Yankelevitz; Daniel M Libby; Mark W Pasmantier; James P Smith; Olli S Miettinen Journal: N Engl J Med Date: 2006-10-26 Impact factor: 91.245
Authors: Denise R Aberle; Sarah DeMello; Christine D Berg; William C Black; Brenda Brewer; Timothy R Church; Kathy L Clingan; Fenghai Duan; Richard M Fagerstrom; Ilana F Gareen; Constantine A Gatsonis; David S Gierada; Amanda Jain; Gordon C Jones; Irene Mahon; Pamela M Marcus; Joshua M Rathmell; JoRean Sicks Journal: N Engl J Med Date: 2013-09-05 Impact factor: 91.245
Authors: Jin Woo Choi; Chang Min Park; Jin Mo Goo; Yang-Kyun Park; Wonmo Sung; Hyun-Ju Lee; Sang Min Lee; Ji Young Ko; Mi-Suk Shim Journal: AJR Am J Roentgenol Date: 2012-09 Impact factor: 3.959
Authors: Soon Ho Yoon; Sang Min Lee; Chul Hwan Park; Jong Hyuk Lee; Hyungjin Kim; Kum Ju Chae; Kwang Nam Jin; Kyung Hee Lee; Jung Im Kim; Jung Hee Hong; Eui Jin Hwang; Heekyung Kim; Young Joo Suh; Samina Park; Young Sik Park; Dong Wan Kim; Miyoung Choi; Chang Min Park Journal: Korean J Radiol Date: 2020-11-19 Impact factor: 3.500