TY - JOUR
T1 - Real-time 3D fluoroscopy-guided large core needle biopsy of renal masses
T2 - A critical early evaluation according to the IDEAL recommendations
AU - Van Den Bosch, Maurice A.A.J.
AU - Kroeze, Stephanie G.C.
AU - Huisman, Merel
AU - Verkooijen, Helena M.
AU - Bosch, J. L.H.Ruud
AU - Van Diest, Paul J.
PY - 2012/6
Y1 - 2012/6
N2 - Introduction Three-dimensional (3D) real-time fluoroscopy cone beam CT is a promising new technique for image-guided biopsy of solid tumors. We evaluated the technical feasibility, diagnostic accuracy, and complications of this technique for guidance of large-core needle biopsy in patients with suspicious renal masses. Methods Thirteen patients with 13 suspicious renal masses underwent large-core needle biopsy under 3D realtime fluoroscopy cone beam CT guidance. Imaging acquisition and subsequent 3D reconstruction was done by a mobile flat-panel detector (FD) C-arm system to plan the needle path. Large-core needle biopsies were taken by the interventional radiologist. Technical success, accuracy, and safety were evaluated according to the Innovation, Development, Exploration, Assessment, Long-term study (IDEAL) recommendations. Results Median tumor size was 2.6 (range, 1.0-14.0) cm. In ten (77%) patients, the histological diagnosis corresponded to the imaging findings: five were malignancies, five benign lesions. Technical feasibility was 77% (10/13); in three patients biopsy results were inconclusive. The lesion size of these three patients was <2.5 cm. One patient developed a minor complication. Median follow-up was 16.0 (range, 6.4-19.8) months. Conclusions 3D real-time fluoroscopy cone beam CT-guided biopsy of renal masses is feasible and safe. However, these first results suggest that diagnostic accuracy may be limited in patients with renal masses <2.5 cm.
AB - Introduction Three-dimensional (3D) real-time fluoroscopy cone beam CT is a promising new technique for image-guided biopsy of solid tumors. We evaluated the technical feasibility, diagnostic accuracy, and complications of this technique for guidance of large-core needle biopsy in patients with suspicious renal masses. Methods Thirteen patients with 13 suspicious renal masses underwent large-core needle biopsy under 3D realtime fluoroscopy cone beam CT guidance. Imaging acquisition and subsequent 3D reconstruction was done by a mobile flat-panel detector (FD) C-arm system to plan the needle path. Large-core needle biopsies were taken by the interventional radiologist. Technical success, accuracy, and safety were evaluated according to the Innovation, Development, Exploration, Assessment, Long-term study (IDEAL) recommendations. Results Median tumor size was 2.6 (range, 1.0-14.0) cm. In ten (77%) patients, the histological diagnosis corresponded to the imaging findings: five were malignancies, five benign lesions. Technical feasibility was 77% (10/13); in three patients biopsy results were inconclusive. The lesion size of these three patients was <2.5 cm. One patient developed a minor complication. Median follow-up was 16.0 (range, 6.4-19.8) months. Conclusions 3D real-time fluoroscopy cone beam CT-guided biopsy of renal masses is feasible and safe. However, these first results suggest that diagnostic accuracy may be limited in patients with renal masses <2.5 cm.
KW - Biopsy
KW - Cone beam computed tomography
KW - IDEAL
KW - Needle guidance
KW - Real-time imaging
KW - Renal masses
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U2 - 10.1007/s00270-011-0237-4
DO - 10.1007/s00270-011-0237-4
M3 - Article
C2 - 21822769
AN - SCOPUS:84864315581
SN - 0174-1551
VL - 35
SP - 680
EP - 685
JO - Cardiovascular and interventional radiology
JF - Cardiovascular and interventional radiology
IS - 3
ER -