C-arm cone-beam computed tomography needle path overlay for percutaneous biopsy of pulmonary nodules

Purpose: The aim of this study was to evaluate the feasibility of percutaneous transthoracic needle biopsy of pulmonary nodules under cone-beam computed tomography (CBCT) with \u201cXperGuide\u201d navigation guidance.Materials and methods: From February 2010 to January 2012, 100 patients (63 men and 37 women; mean age 67.27\ua0years; range 21\u201388\ua0years) with 100 lung nodules (44\ua0 64\ua03\ua0cm, 56\ua0>\ua03\ua0cm) underwent CBCT-XperGuide guided percutaneous transthoracic needle biopsies. Technical success, diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and complications were evaluated.Results: Of 100 nodules (mean size 5.19\ua0cm), 68 were diagnosed as malignant, 27 as benign, and five as indeterminate. Technical success was 95\ua0%. Only 33 of 100 patients underwent surgery: the final pathological diagnosis was concordant with the biopsy diagnosis in 26 cases and discordant in 7 cases (false negatives). Accuracy, sensitivity, specificity, PPV and NPV were 92.6, 90.9, 100, 100 and 72\ua0%, respectively.Conclusions: CBCT-XperGuide navigation is a new, accurate and safe imaging guidance for percutaneous lung biopsies