C-arm cone-beam CT-guided percutaneous transthoracic lung biopsy: usefulness in evaluation of small pulmonary nodules

AJR Am J Roentgenol. 2010 Dec;195(6):W400-7. doi: 10.2214/AJR.09.3963.

Abstract

Objective: The purpose of this study was to evaluate the usefulness of C-arm conebeam CT-guided percutaneous transthoracic lung biopsy of small (≤ 2 cm) lung nodules.

Materials and methods: Twenty-seven patients who underwent C-arm cone-beam CT-guided percutaneous transthoracic lung biopsy of small (≤ 2 cm) lung nodules were enrolled in the study. The mean nodule size was 13 ± 4 mm in diameter. These lesions were divided into two groups according to size: 10 lesions 1 cm or smaller and 17 lesions larger than 1 cm. The diagnostic accuracy, sensitivity, and specificity in the two groups were compared by use of Fisher's exact test. Radiation dose in a female humanoid phantom was measured with radiophotoluminescent glass dosimeters. The average patient dose was calculated.

Results: Eighteen malignant (67%) and eight benign (30%) nodules and one (3%) indeterminate nodule were found. The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 94%, 89%, 94%, 89%, and 92%. The sensitivity, specificity, and accuracy were 100%, 75%, and 90% for the lesions 1 cm or smaller and 91%, 100%, and 94% for the lesions larger than 1 cm. The accuracy, sensitivity, and specificity did not differ significantly between the groups (all p > 0.05, Fisher's exact test). The average radiation dose among 27 patients was 4.6 mSv (range, 2.19-9.37).

Conclusion: C-arm cone-beam CT-guided percutaneous transthoracic lung biopsy is a useful diagnostic technique in the evaluation of small lung nodules.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Needle / methods*
  • Cone-Beam Computed Tomography*
  • Female
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology*
  • Male
  • Middle Aged
  • Phantoms, Imaging
  • Predictive Value of Tests
  • Radiation Dosage
  • Radiographic Image Interpretation, Computer-Assisted
  • Radiography, Interventional / methods*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Solitary Pulmonary Nodule / diagnostic imaging*