OBJECTIVE:To determine whether 3D cone-beam computed tomography (CBCT) guidance allows safe and accurate biopsy of suspected small renal masses (SRM), especially in hard-to-reach anatomical locations.
MATERIALS AND METHODS:CBCT guidance was used to perform 41 stereotactic biopsy procedures of lesions that were inaccessible for ultrasound guidance or CT guidance. In CBCT guidance, a 3D-volume data set is acquired by rotating a C-arm flat-panel detector angiosystem around the patient. In the data set, a needle trajectory is determined and, after co-registration, a fusion image is created from fluoroscopy and a slice from the data set, enabling the needle to be positioned in real time.
RESULTS: Of the 41 lesions, 22 were malignant, 17 were benign, and 2 were nondiagnostic. The two nondiagnostic lesions proved to be renal cell carcinoma. There was no growth during follow-up imaging of the benign lesions (mean 29 months). This resulted in a sensitivity, specificity, PPV, NPV, and accuracy of 91.7, 100, 100, 89.5, and 95.1%, respectively. Mean dose-area product value was 44.0 Gy·cm2(range 16.5-126.5). There was one minor bleeding complication.
CONCLUSION: With CBCT guidance, safe and accurate biopsy of a suspected SRM is feasible, especially in hard-to-reach locations of the kidney.
Written by:
Braak SJ, van Melick HH, Onaca MG, van Heesewijk JP, van Strijen MJ. Are you the author?
Department of Radiology, St Antonius Hospital, PO Box 2500, 3430 EM, Nieuwegein, The Netherlands.
Reference: Eur Radiol. 2012 Jun 2. Epub ahead of print.
doi: 10.1007/s00330-012-2498-y
PubMed Abstract
PMID: 22660984
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