Flat detector C-arm CT-guided transthoracic needle biopsy of small (aparts per thousandcurrency sign2.0 cm) pulmonary nodules: diagnostic accuracy and complication in 100 patients

This study aimed at assessing the usefulness of flat detector cone-beam CT virtual navigation-guided transthoracic needle biopsy of small (a parts per thousand currency sign2.0 cm) pulmonary nodules in terms of diagnostic accuracy and complications to evaluate the diagnostic performance and complications of small pulmonary nodules under cone-beam CT (CBCT) guidance. A total of 100 patients with 100 solid lung nodules were retrospectively enrolled to undergo transthoracic needle biopsy (TNB) procedures. The mean diameter of lesions was 1.25 cm +/- A 0.39 (range 0.50-2.00 cm). The needle path was carefully planned and calculated on the CBCT virtual navigation guidance system, which acquired 3D CT-like cross-sectional images. Diagnostic performance, complication rate, and patient radiation exposure were investigated. The technical success rate of TNB under iGuide CBCT virtual navigation system was 99 % (99/100). The sensitivity, specificity, and accuracy of TNB of small nodules under iGuide CBCT virtual navigation guidance were 98.7 % (77/78), 90.5 % (19/21), and 97.0 % (96/99), respectively. The number of pleural passages with coaxial needle, biopsies, and CBCT acquisitions were 1.09 +/- A 0.32, 1.20 +/- A 0.47, and 3.06 +/- A 1.35, respectively. Complications occurred in 22 (22 %) cases. The mean total procedure time was 12.84 min +/- A 3.74, resulting in a mean exposure dose of 7.6 mSv +/- 3.1. Flat detector Cone-beam CT-guided TNB is a highly accurate and safe diagnostic method for small (a parts per thousand currency sign2.0 cm) lung nodule.