Virtual monochromatic spectral imaging versus linearly blended dual-energy and single-energy imaging during CT-guided biopsy needle positioning: Optimization of keV settings and impact on image quality

Purpose To evaluate dual-energy CT (DE) and dedicated metal artifact reduction algorithms (iMAR) during CT-guided biopsy in comparison to single-energy CT (SE). Methods A trocar was placed in the liver of six pigs. CT acquisitions were performed with SE and dose equivalent DE at four dose levels(1.7–13.5mGy). Iterative reconstructions were performed with and without iMAR. ROIs were placed in four positions e.g. at the trocar tip(TROCAR) and liver parenchyma adjacent to the trocar tip(LIVER-1) by two independent observers for quantitative analysis using CT numbers, noise, SNR and CNR. Qualitative image analysis was performed regarding overall image quality and artifacts generated by iMAR. Results There were no significant differences in CT numbers between DE and SE at TROCAR and LIVER-1 irrespective of iMAR. iMAR significantly reduced metal artifacts at LIVER-1 for all exposure settings for DE and SE(p = 0.02-0.04), but not at TROCAR. SNR, CNR and noise were comparable for DE and SE. SNR was best for high dose levels of 6.7/13.5mGy. Mean difference in the Blant-Altman analysis was -8.43 to 0.36. Cohen’s kappa for qualitative interreader-agreement was 0.901. Conclusions iMAR independently reduced metal artifacts more effectively and efficiently than CT acquisition in DE at any dose setting and its application is feasible during CT-guided liver biopsy.

Download Full-text

CT-guided biopsy of pulmonary nodules less than 3 cm: usefulness of the spring-operated core biopsy needle and frozen-section pathologic diagnosis.

American Journal of Roentgenology ◽

10.2214/ajr.170.2.9456939 ◽

1998 ◽

Vol 170 (2) ◽

pp. 329-331 ◽

Cited By ~ 36

Author(s):

N Hayashi ◽

T Sakai ◽

M Kitagawa ◽

T Kimoto ◽

R Inagaki ◽

...

Keyword(s):

Core Biopsy ◽

Frozen Section ◽

Pulmonary Nodules ◽

Ct Guided ◽

Biopsy Needle ◽

Pathologic Diagnosis ◽

Guided Biopsy ◽

Ct Guided Biopsy

Download Full-text

Needle-in-Needle Technique for Percutaneous Retrieval of a Fractured Biopsy Needle during CT-Guided Biopsy of the Thoracic Spine

Interventional Neuroradiology ◽

10.15274/inr-2014-10061 ◽

2014 ◽

Vol 20 (5) ◽

pp. 646-649 ◽

Cited By ~ 6

Author(s):

Hamza Shaikh ◽

Jayesh Thawani ◽

Bryan Pukenas

Keyword(s):

Vertebral Body ◽

Bone Biopsy ◽

Large Diameter ◽

Needle Aspiration ◽

Aortic Injury ◽

Csf Leak ◽

Ct Guided ◽

Biopsy Needle ◽

Guided Biopsy ◽

Ct Guided Biopsy

Common complications related to CT-guided percutaneous thoracic bone biopsy procedures include pneumothorax and muscular hematoma. Serious, but rare complications include paralysis, nerve injury, CSF leak, and aortic injury. Device failure has not been well documented in the literature. We discuss our experience with biopsy needle breakage during retrieval of a core specimen and the technique used to help retrieve an embedded needle using a CT fluoroscopic-guided, needle-in-needle approach. A 43 year-old man with Stage IIIa NSCLC was found to have a T11 vertebral body lesion as seen on PET, CT, and MR imaging. The patient underwent a CT-guided biopsy in the prone position. The T11 vertebral body was localized and cannulated using the percutaneous Bonopty® (Apriomed, Upsala, Sweden) needle device. After fine needle aspiration samples were obtained, a core needle biopsy was attempted with a 16-gauge device. The needle fractured 4 cm deep to the skin during removal of a sclerotic lesion, leaving a retained portion within the pedicle and vertebral body. Using CT-guided fluoroscopy, a large diameter Murphy M2 needle was advanced over the distal portion of the fractured Bonopty needle. The Murphy M2 needle was advanced distal to the tip of the Bonopty needle and removed, capturing the broken Bonopty penetration needle along with a core specimen. Larger-bore biopsy needle systems and/or a coaxial system should be used to perform core biopsies in sclerotic lesions to prevent device fracture. If there is device fracture, a larger-bore needle may be used to help capture the fractured needle and prevent open surgery.

Download Full-text

In vitro CT visualization of the biopsy location by filling the core biopsy needle with contrast media

Acta Radiologica ◽

10.1177/02841851211041831 ◽

2021 ◽

pp. 028418512110418

Author(s):

Per Thunswärd ◽

David Eksell ◽

Håkan Ahlström ◽

Anders Magnusson

Keyword(s):

Contrast Media ◽

Core Biopsy ◽

Sampling Location ◽

Ct Guided ◽

Biopsy Needle ◽

Tissue Phantom ◽

Guided Biopsy ◽

Ct Guided Biopsy ◽

Novel Method

Background When performing computed tomography (CT)-guided biopsy procedures with non-disposable, automatic biopsy instruments, the actual course of the biopsy needle is not registered. Purpose To evaluate the ability to visualize the sampling location after CT-guided biopsy in vitro using a novel method, where the space between the inner needle and the outer cannula in a core biopsy needle is filled with contrast media; and to compare the grade of visibility for two different concentrations of contrast media. Material and Methods Core needle biopsies were performed in a tissue phantom using biopsy needles primed with two different iodine contrast media concentrations (140 mg I/mL and 400 mg I/mL). Commercially available needle-filling contraptions with sealing membranes were used to fill the needles. Each biopsy was imaged with CT, and the visibility was evaluated twice by three senior radiologists in a randomized order. Results The presence of traces was confirmed after biopsy, almost without exception for both concentrations. The visibility was sufficient to determine the biopsy location in all observations with the 400 mg I/mL filling, and in 7/10 observations with the 140 mg I/mL filling. The grade of visibility of the trace and the proportion of the biopsy needle course outlined were higher with the 400 mg I/mL filling. Conclusion With CT-guided biopsy in vitro, the sampling location can be visualized using a novel method of priming the biopsy needle with iodine contrast media, specifically highly concentrated contrast media.

Download Full-text