Biopsy of lung nodules with use of I-I device under intermittent CT fluoroscopic guidance: Preliminary clinical study

PURPOSE: To investigate the efficacy of computed tomography (CT) fluoroscop y and a new needle holder (the I-I device) in lung nodule biopsy. MATERIALS AND METHODS: The I-I device is made of acrylate resin and was use d to keep the entire needle in the tomographic plane. This study consisted of biopsies of 79 lung nodules in 77 patients. The final diagnoses were mal ignant in 54 patients, benign in 23, and unconfirmed in two. The biopsy pro cedure time from the beginning of the CT fluoroscopy procedure to the remov al of the needle was measured for 24 needle passes. The radiation dose on t he physician's hand was measured in five cases with use of a thermoluminesc ence ring. RESULTS: Fifty-one malignant and 20 benign lesions were correctly diagnosed with histologic specimens (90%). In 58 of 77 patients (75%), the biopsy pr ocedures were completed within a single breath-hold. Pneumothorax occurred in 20 of 77 patients (26%) and chest tube insertion was required in five. T he incidence of pneumothorax was significantly lower in patients who held t heir breath during biopsy procedures compared with those who did not (P <.0 001; <chi>(2) test). The biopsy procedure time ranged from 15 to 39 seconds (mean: 28.2 sec). The mean radiation dose on the physician's hand was 2 mS v/case. CONCLUSION: The diagnostic accuracy of biopsy with use of the I-I device un der CT fluoroscopic guidance is comparable with that of the conventional me thod; however, a combination of CT fluoroscopy and the I-I device enables r apid biopsy procedures.