CT-Fluoroscopy versus Conventional Helical CT Guidance for Lung Biopsies Performed By Clinical Fellows without Prior Training: Radiation Dose and Workflow

Abstract

Purpose: To analyse the impact of CT-fluoroscopy versus conventional CT-guidance in lung biopsies, performed by radiologists (clinical fellows) without prior CT-fluoroscopy experience, on radiation dose and navigation time. Material and Methods: Ninety-one consecutive patients referred for CT-guided chest biopsies within the first half of the academic year were retrospectively analysed. All biopsies were performed by three clinical fellows who had pre-existing experience with conventional CT-guided biopsies but were novices to CT-fluoroscopy guidance. Needle navigation was guided by helical CT mode in 45 patients (Group I) and by CT fluoroscopy in 46 patients (Group II). Patient age, gender, lesion size, site of the lesion, depth (skin to lesion, pleura to lesion), complications, navigation time and DLP were recorded and statistically compared. Results: Mean patient radiation dose (DLP, mGy*cm) was 76.12 (SD: 57.72) in Group I (~ 1.29 mSv) and 59.59 (SD: 36.28) in Group II (~1.01 mSv) (p=0.05). Navigation time of 21 min (SD: 14) in Group I was significantly longer than 12 min in Group II (SD: 9) (p=0.0004). All other parameters did not show significant differences between the two groups. Conclusion: CT-fluoroscopy guidance in lung biopsies performed by fellows leads to shorter navigation time and lower radiation dose to the patients.