Clinical Efficacy and Economic Impact of an Augmented Reality Navigation System: Experience On 498 Percutaneous Computed Tomogaphy-Guided Pulmonary Biopsies

Background: To validate the reality navigation system SIRIO performance on CT-guided percutaneous pulmonary biopsy (PLB). Complications rate and histological sample quality were evaluated, in relation to lesion size and location. The economic impact was analyzed by comparing device and patient management costs and refunds by national healthcare system. Method(s): 496 patients over 18 years with lung nodules suspected of malignancy and non-diagnostic bronchoscopy or inadequate us-guided biopsy, were included. Patients with an affected coagultive profile or performance status were excluded. Maximum lesion diameter (ID), distance between lesion and pleural surface (DPS), distance traveled by the needle (DTP), procedure timing (PT) and validity of histological sample were evaluated. Costs for the consumptive material, procedure, CT and histocytopathologic analysis of the sample were analyzed, considering surgical day-hospital and PAC (comprehensive outpatient performance) as two different repayment options. Result(s): Histopathological diagnosis was obtained in 96.2%. LD mean was 20.7 mm, DPS 12.4 mm, DTP 7.9 mm and PT 29.5 minutes. The thoracic radiation dose was 51.2±49.1 mGy-cm. Procedural complications were reported in 156 cases, with 23 (4.6%) major complications. In these cases, DTP was significantly higher. About economical analysis, 44 PLB/month for 4 years, considering day-hospital, and 33 PLB/month for 2 years, considering PAC, are needed to get a complete depreciation. Conclusion(s): SIRIO is a useful tool for improving success rate and diagnostic accuracy with a significant reduction of complications and pt. Economic analysis is also positive, not considering its possible use for tumor ablation, with much higher refunds.

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Artikel online veröffentlicht:
11. Mai 2021