Evaluation of an Interactive Breath-Hold Control System in CT-Guided Lung Biopsy

Zusammenfassung

Ziel: Wir evaluierten den Einfluss eines interaktiven Atemkontrollsystems bei der CT-gesteuerten Lungenbiopsie auf die Interventionszeit und den technisch erfolgreichen Abschluss. Material und Methoden: Wir führten bei 36 Patienten (4 weiblich, 32 männlich, mittleres Alter 65 Jahre; 33 – 88 Jahre) mit einem Lungenherd eine CT-gesteuerte Lungenbiopsie durch. Wir setzten eine 18G-Tru-cut-Biopsienadel (Cardinal Health, Dublin, UK) in einem 64 Zeilen-Dual-Source-CT (Somatom Definition, Siemens, Forchheim, Deutschland) bei intermittierender Bildgebung der Nadel ein. Bei der Hälfte der Patienten (2 weiblich, 16 männlich, mittleres Alter 67 Jahre) kam zusätzlich ein interaktives Atemkontrollsystem (IBC) (Mayo Clinic Medical Devices, USA) zur Anwendung. In der Kontrollgruppe wurde die Lungenbiopsie ohne ein solches System durchgeführt. Ergebnisse: Die Biopsie wurde bei allen Patienten technisch erfolgreich durchgeführt. Der Durchmesser des Zielherds war in beiden Gruppen vergleichbar (IBC: 30 ± 19 mm; Kontrolle: 28 ± 15 mm). Die Anzahl der benötigten Kontrollbildgebungen war in der IBC-Gruppe signifikant geringer (p < 0,05) und die Interventionszeit signifikant kürzer (p < 0,05) (IBC: 9 ± 5 Bildgebungsschritte, 17 ± 10 min; Kontrolle: 13 ± 5 Bildgebungsschritte, 26 ± 12 min). Schlussfolgerung: Durch Einsatz eines interaktiven Atemkontrollsystems war es möglich, die Interventionszeit und die Strahlenbelastung bei CT-gesteuerten Lungenbiopsien zu reduzieren.

Abstract

Purpose: In this study we assessed the effect of an interactive breath-hold control system on procedure time and technical success in transthoracic CT-guided lung biopsies. Materials and Methods: In 36 patients (4 female, 32 male, mean age 65 years; range 33 – 88) with a pulmonary nodule, we performed CT-guided biopsy using a 18G Tru-cut needle (Cardinal Health, Dublin, UK) in a 64 row dual-source CT scanner (Somatom Definition, Siemens, Forchheim, Germany) using intermittent imaging of the needle. In half of the patients (2 female, 16 male, mean age 67 years), an interactive breath-hold control system (IBC) (Mayo Clinic Medical Devices, USA) was applied. No additional device was used in the control group. Results: The biopsy was visually successful in all patients. The diameter of the target lesion was comparable in both groups (IBC: 30 ± 19 mm; control: 28 ± 15 mm). The number of imaging steps was significantly smaller (p < 0.05) and the intervention time was significantly shorter (p < 0.05) in the IBC group (IBC: 9 ± 5 steps 17 ± 10 min; control: 13 ± 5 steps 26 ± 12 min). Conclusion: Application of the IBC unit reduced the intervention time and radiation exposure in CT-guided Tru-cut biopsy of pulmonary nodules.

Key words

thorax - biopsy - CT

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