NEW OPTICAL NAVIGATION SYSTEM FOR CT-GUIDED LUNG BIOPSIES: INITIAL HUMAN EXPERIENCE

Aims and background “Augmented reality” is a technique to create a composite view by augmenting the real intervention field, visualized by the doctor, with additional information coming from a virtual volume generated using computed tomography (CT), magnetic resonance or ultrasound images previously acquired from the same patient. In the present study we verified the accuracy and validated the clinical use of an augmented reality navigation system produced to perform percutaneous CT-guided lung biopsies. Methods One hundred and eighty consecutive patients with solitary parenchymal lung lesions, enrolled using a nonrandom enrollment system, underwent percutaneous CT-guided aspiration and core biopsy using a traditional technique (group C, 90 patients) and navigation system assistance (group S, 90 patients). For each patient we recorded the largest lesion diameter, procedure time, overall number of CT scans, radiation dose, and complications. The entire experimental project was evaluated and approved by the local institutional review board (ethics committee). Results Each procedure was concluded successfully and a pathological diagnosis was reached in 96% of cases in group S and 90% of cases in group C. Procedure time, overall number of CT scans and incident x-ray radiation dose (CTDIvol) were significantly reduced in navigation system-assisted procedures (P <0.001; z = 5.64) compared with traditional CT-guided procedures. The percentage of procedural complications was 14% in group S and 17% in group C. Conclusion The augmented reality navigation system used in this study was a highly safe, technically reliable and effective support tool in percutaneous CT-guided lung biopsy, allowing to shorten the procedure time and reduce the incident x-ray radiation dose to patients and the rate of insufficient specimens. Furthermore, it has the potential to increase the number of procedures executed in the allocated time without increasing the number of complications.

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Implementation of ultra-low-dose lung protocols in CT-guided lung biopsies: feasibility and safety in the clinical setting

Journal of International Medical Research ◽

10.1177/0300060517712165 ◽

2017 ◽

Vol 45 (6) ◽

pp. 2101-2109 ◽

Cited By ~ 3

Author(s):

Barbara K Frisch ◽

Karin Slebocki ◽

Kamal Mammadov ◽

Michael Puesken ◽

Ingrid Becker ◽

...

Keyword(s):

Image Quality ◽

Radiation Dose ◽

Low Dose ◽

Standard Dose ◽

Complication Rates ◽

Dose Length Product ◽

Ct Guided ◽

Total Radiation Dose ◽

Lung Biopsies ◽

Histological Results

Objective To evaluate the use of ultra-low-dose computed tomography (ULDCT) for CT-guided lung biopsy versus standard-dose CT (SDCT). Methods CT-guided lung biopsies from 115 patients (50 ULDCT, 65 SDCT) were analyzed retrospectively. SDCT settings were 120 kVp with automatic mAs modulation. ULDCT settings were 80 kVp with fixed exposure (20 mAs). Two radiologists evaluated image quality (i.e., needle artifacts, lesion contouring, vessel recognition, visibility of interlobar fissures). Complications and histological results were also evaluated. Results ULDCT was considered feasible for all lung interventions, showing the same diagnostic accuracy as SDCT. Its mean total radiation dose (dose–length product) was significantly reduced to 34 mGy-cm (SDCT 426 mGy-cm). Image quality and complication rates ( P = 0.469) were consistent. Conclusions ULDCT for CT-guided lung biopsies appears safe and accurate, with a significantly reduced radiation dose. We therefore recommend routine clinical use of ULDCT for the benefit of patients and interventionalists.

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Dynamic telecytologic evaluation of imprint cytology samples from CT-guided lung biopsies: A feasibility study

European Radiology ◽

10.1007/s00330-011-2137-z ◽

2011 ◽

Vol 21 (9) ◽

pp. 1922-1927 ◽

Cited By ~ 3

Author(s):

Helmut Prosch ◽

Elisabeth Hoffmann ◽

Klaus Bernhardt ◽

Johann Schalleschak ◽

Ewald Schober ◽

...

Keyword(s):

Feasibility Study ◽

Imprint Cytology ◽

Ct Guided ◽

Lung Biopsies

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Cost-effectiveness of hydrogel plugs in CT-guided lung biopsies

Radiología (English Edition) ◽

10.1016/j.rxeng.2019.01.007 ◽

2019 ◽

Vol 61 (2) ◽

pp. 153-160

Author(s):

S.F. Marco-Doménech ◽

P. Fernández-García ◽

A. Navarro-Ballester ◽

M. Cifrián-Pérez ◽

Á. Escobar-Valero ◽

...

Keyword(s):

Cost Effectiveness ◽

Ct Guided ◽

Lung Biopsies

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Development of a test bench for insertion force measurements with precise orientation of specimen using a stereo optical navigation system

10.1055/s-0039-1686402 ◽

2019 ◽

Author(s):

S Hügl ◽

M Henke ◽

LA Kahrs ◽

T Ortmaier ◽

T Lenarz ◽

...

Keyword(s):

Navigation System ◽

Test Bench ◽

Optical Navigation ◽

Force Measurements ◽

Insertion Force

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Development of a robotic FD-CT-guided navigation system for needle placement-preliminary accuracy tests

International Journal of Medical Robotics and Computer Assisted Surgery ◽

10.1002/rcs.393 ◽

2011 ◽

Vol 7 (2) ◽

pp. 225-236 ◽

Cited By ~ 32

Author(s):

Saúl Tovar-Arriaga ◽

Ralf Tita ◽

Jesús Carlos Pedraza-Ortega ◽

Efren Gorrostieta ◽

Willi A. Kalender

Keyword(s):

Navigation System ◽

Needle Placement ◽

Ct Guided

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FNA and CNB in the Diagnosis of Pulmonary Lesions: A Single-center Experience on 665 Patients, Comparison between Two Periods

Tumori Journal ◽

10.5301/tj.5000633 ◽

2017 ◽

Vol 103 (4) ◽

pp. 360-366 ◽

Cited By ~ 2

Author(s):

Alfonso Vittorio Marchianò ◽

Maria Cosentino ◽

Giuseppe Di Tolla ◽

Francesca Gabriella Greco ◽

Mario Silva ◽

...

Keyword(s):

Needle Biopsy ◽

Diagnostic Yield ◽

Needle Aspiration ◽

Complication Rates ◽

Multivariate Logistic Regression ◽

Ct Guided ◽

Fine Needle ◽

Pulmonary Lesions ◽

Single Center Experience ◽

Lung Biopsies

Purpose To evaluate the diagnostic yield and complication rate of 2 different biopsy techniques (fine-needle aspiration, FNA, and core-needle biopsy, CNB) in the diagnosis of pulmonary lesions in 2 distinct periods, 2010-2012 and 2013-2015. Methods We retrospectively analyzed the results of 691 CT-guided lung biopsies in 665 patients who were divided into 2 groups: cohort 1 (January 2010 to December 2012) was composed of 271 consecutive patients with 284 procedures either by FNA or CNB; cohort 2 (January 2013 to December 2015) was composed of 394 patients with 407 CNBs. Univariate and multivariate logistic regression modeling was used for selected outcomes including diagnostic yield, bleeding and pneumothorax. Results Cohort 1 comprised 165 men and 106 women (mean age 68.5 years) with 180 FNAs and 104 CNBs; cohort 2 comprised 229 men and 165 women (mean age 66.4 years) with 407 CNBs. The diagnostic yield increased in cohort 2 with respect to cohort 1. There was a slight increase in CT procedure complications (pneumothorax and bleeding) from cohort 1 to cohort 2. The overall risk of complications was greater for lesions <20 mm and for lesions at >20 mm distance from the pleura. Conclusions CT-guided CNB had a higher diagnostic yield than discretional use of either FNA or CNB; there was a slight but acceptable increase in complication rates.

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