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PurposeTo compare cone-beam computed tomography (CT) navigation vs conventional CT image guidance during biopsies.Materials and methodsPatients scheduled for image-guided biopsies were prospectively and randomly assigned to conventional CT guidance vs cone-beam CT navigation. Radiation dose, accuracy of final needle position, rate of histopathologic diagnosis, and number of needle repositions to reach the target (defined as pullback to adjust position) were compared.ResultsA total of 58 patients (mean age, 57 y; 62.1% men) were randomized: 29 patients underwent 33 biopsies with CT guidance and 29 patients with 33 lesions underwent biopsy with cone-beam CT navigation. The average body mass index (BMI) was similar between groups, at 28.8 kg/m(2) ± 6.55 (P = .18). There was no difference between groups in terms of patient and lesion characteristics (eg, size, depth). The average lesion size was 29.1 ± 12.7mm for CT group vs 32.1mm ±16.8mm for cone-beam CT group (P < 0.59). Location of lesions was equally divided between the 2 groups, 20 lung lesions, 18 renal lesions and 20 other abdominal lesions. Mean number of needle repositions in the cone-beam CT group was 0.3 ± 0.5, compared with 1.9 ± 2.3 with conventional CT (P < .001). The average skin entry dose was 29% lower with cone-beam CT than with conventional CT (P < .04 accounting for BMI). The average estimated effective dose for the planning scan from phantom data was 49% lower with cone-beam CT vs conventional CT (P = .018). Accuracy, defined as the difference between planned and final needle positions, was 4.9 mm ± 4.1 for the cone-beam CT group, compared with 12.2 mm ± 8.1 for conventional CT (P < .001). Histopathologic diagnosis rates were similar between groups, at 90.9% for conventional CT and 93.9% for cone-beam CT (P = .67).ConclusionsCone-beam CT navigation for biopsies improved targeting accuracy with fewer needle repositions, lower skin entry dose, and lower effective dose for planning scan, and a comparable histopathologic diagnosis rate.

The operating characteristics of a two-cavity X-band gyroklystron experiment are reported. Beam voltages and currents up to 440 kV and 200 A, respectively, are generated in 1 is pulses by a thermionic magnetron injection gun. Velocity ratios [mathematical expression omitted] near one in the output cavity are used to achieve peak powers of 24 MW near 9.87 Ghz. The maximum saturated efficiency of more than 33% occurs at a beam voltage of 425 kV and a current of 150 A. A large signal gain in excess of 34 dB is realized by operating the input cavity just below the start oscillation threshold. Details of tube stability and the dependence of amplification on magnetic field profile, input signal parameters, and various beam quantities are presented.

A straightforward method is presented to estimate peak skin doses (PSDs) delivered by computed tomography (CT) scanners. The measured PSD values are related to the well-known volume CT dose index (CTDIvol), displayed on the console of CT scanners. PSD measurement estimates were obtained, in four CT units, by placing radiochromic film on the surface of a CTDI head phantom. Six different X-ray tube currents including the maximum allowed value were used to irradiate the phantom. PSD and CTDIvol were independently measured and later related to the CTDIvol value displayed on the console. A scanner-specific relationship was found between the measured PSD and the associated CTDIvol displayed on the console. The measured PSD values varied between 27 and 136 mGy among all scanners when the routine head scan parameters were used. The results of this work allow relating the widely used CTDIvol to an actual radiation dose delivered to the skin of a patient. [ABSTRACT FROM PUBLISHER]