CT-Guided Liver Biopsy With Electromagnetic Tracking: Results From a Single-Center Prospective Randomized Controlled Trial
| Autor: | Aaron M. Fischman, Robert A. Lookstein, Edward Kim, Thomas J. Ward, S.F. Nowakowski, Rahul S. Patel |
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| Rok vydání: | 2014 |
| Předmět: |
Image-Guided Biopsy
Male Target lesion medicine.medical_specialty Single Center Sensitivity and Specificity law.invention Lesion Electromagnetic Fields Randomized controlled trial law Biopsy medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Electromagnetic tracking medicine.diagnostic_test business.industry Liver Neoplasms Reproducibility of Results General Medicine Micro-Electrical-Mechanical Systems Middle Aged Liver Liver lesion Liver biopsy Female Radiology medicine.symptom Tomography X-Ray Computed business |
| Zdroj: | American Journal of Roentgenology. 203:W715-W723 |
| ISSN: | 1546-3141 0361-803X |
| DOI: | 10.2214/ajr.13.12061 |
| Popis: | The purpose of this study is to evaluate the effectiveness of electromagnetic tracking in assisting CT-guided liver biopsies.This was a single-center prospective randomized controlled trial comparing nonfluoroscopic CT-guided liver biopsy using an advance-and-scan technique with and without electromagnetic tracking. Fifty patients with a liver lesion referred for biopsy (women, 52%; mean age, 59.7 years; mean lesion size, 3.6 cm) were enrolled in the study and were randomly assigned to either arm. The primary and secondary objectives were to assess and quantify differences in the number of intraprocedural scans, cumulative effective radiation dose, number of needle manipulations, and procedure time from skin-stick to the target lesion with and without assistance.Electromagnetic tracking significantly decreased the number of scans, effective radiation dose, number of manipulations per procedure, and time from skin-stick to the target lesion. The ratio of the number of scans (electromagnetic tracking to control) was 0.55 (95% CI, 0.42-0.73; p0.0001). The mean difference in effective radiation dose (electromagnetic tracking-control) was -4.7 mSv (95% CI, -7.01 to -2.44 mSv; p=0.0001), and the median difference was -5.1 mSv (95% CI, -7.01 to -3.56 mSv; p0.0001). The ratio of the number of manipulations (electromagnetic tracking to control) was 0.36 (95% CI, 0.24-0.54; p0.0001). The mean difference for the time from skin-stick to the target lesion was -247.6 seconds (95% CI, -394.34 to -100.83 seconds; p=0.0014) and the median difference was -253.0 seconds (95% CI, -325.00 to -124.00 seconds; p=0.0001).Electromagnetic tracking assistance has the potential to decrease the number of intraprocedural CT scans and needle manipulations and to reduce patient radiation dose during CT-guided liver biopsy. |
| Databáze: | OpenAIRE |
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