C-arm cone-beam CT virtual navigation-guided percutaneous mediastinal mass biopsy: Diagnostic accuracy and complications

Abstract

To assess the usefulness of C-arm cone-beam computed tomography (CBCT) virtual navigation-guided percutaneous mediastinal mass biopsy in terms of diagnostic accuracy and complication rates. Seventy-eight CBCT virtual navigation-guided percutaneous mediastinal mass biopsies were performed in 75 patients (M:F, 38:37; mean age, 48.55 +/- 18.76 years). The procedural details, diagnostic sensitivity, specificity, accuracy and complication rate were investigated. Mean lesion size was 6.80 +/- 3.08 cm, skin-to-target distance was 3.67 +/- 1.80 cm, core needle biopsy rate was 96.2 % (75/78), needle indwelling time was 9.29 +/- 4.34 min, total procedure time was 13.26 +/- 5.29 min, number of biopsy specimens obtained was 3.13 +/- 1.02, number of CBCTs performed was 3.03 +/- 0.68, rate of lesion border discrimination from abutting mediastinal structures on CBCT was 26.9 % (21/78), technical success rate was 100 % (78/78), estimated effective dose was 5.33 +/- 4.99 mSv, and the dose area product was 12,723.68 +/- 10,665.74 mGya <...cm(2). Among the 78 biopsies, 69 were malignant, 7 were benign and 2 were indeterminate. Diagnostic sensitivity, specificity and accuracy for the diagnosis of malignancies were 97.1 % (67/69), 100 % (7/7) and 97.4 % (74/76), respectively, with a complication rate of 3.85 % (3/78), all of which were small pneumothoraces. CBCT virtual navigation-guided biopsy is a highly accurate and safe procedure for the evaluation of mediastinal lesions. aEuro cent CBCT virtual navigation-guided percutaneous mediastinal biopsy is highly accurate aEuro cent CBCT virtual navigation-guided percutaneous mediastinal biopsy is a safe procedure aEuro cent Mediastinal vascular injury can be avoided under CBCT virtual navigation guidance.