CT fluoroscopy-guided lung biopsy versus conventional CT-guided lung biopsy: A prospective controlled study to assess radiation doses and diagnostic performance

Objective: We evaluated radiation doses, complication rates, and diagnostic accuracy for CT-guided percutaneous needle aspiration biopsy (NAB) procedures of pulmonary lesions performed with or without fluoroscopic guidance. Methods: A total of 142 patients were prospectively enrolled to receive CT-guided NAB with (Group I, n∈=∈72) or without (Group II, n∈=∈70) fluoroscopic guidance. Outcome measurements were patient and doctor radiation dose, and complication rate. Sensitivity, specificity and accuracy were calculated based on 123 NAB results. Results: The mean estimated effective patient radiation dose was 6.53 mSv in Group I and 2.72 mSv in Group II (p∈<∈0.001). The mean estimated effective doctor dose was 0.054 mSv in Group I and 0.029 mSv in Group II (p < 0.001). The complication rate was significantly different between the two groups (13.4% versus 31.4%, p∈=∈0.012). Sensitivity, specificity and accuracy for diagnosing pulmonary lesions were 97.8%, 100% and 98.4% in group I and 95.3%, 100% and 89.5% in group II (p∈>∈0.05). Conclusions: CT fluoroscopy-guided NAB of pulmonary lesions provides high diagnostic accuracy and can be performed with significantly fewer complications. However, radiation exposure to both patient and doctor were significantly higher than conventional CT-guided NAB.