Guidance of percutaneous pulmonary biopsies with real-time CT fluoroscopy

Objective: Clinical evaluation of computed tomography (CT) fluoroscopy and comparison with conventional CT guidance for monitoring of percutaneous pulmonary biopsy procedures. Methods: Twenty CT-guided pulmonary biopsy procedures were conducted. The interventions have prospectively been performed either with CT fluoroscopy or with conventional CT guidance. About 120 kV and 50 mA with a frame-rate of eight images per second were used for CT fluoroscopy. Number of pleural needle passages, procedure times, radiation doses and histologic results were analyzed separately for both methods. Results: Compared with conventional CT guidance, CT fluoroscopy was associated with less pleural needle passages (1.8±0.6 vs. 1.1±0.3; P =0.003, t -test) and procedure times were shorter than for conventional CT guidance (12.7±2.2 min vs. 26.7±16.4 min; P =0.02). Analysis of estimated patient related radiation exposure and histologic outcome showed no significant difference between conventional and fluoroscopic CT-guided procedures ( P >0.05). Conclusion: CT fluoroscopy facilitates guidance of percutaneous pulmonary biopsy procedures. Compared with conventional CT assistance, procedure times are decreased and less pleural needle passages are required. While patient-related radiation exposure is similar, operator-related radiation exposure remains a disadvantage associated with CT fluoroscopy.