Percutaneous bone biopsies: comparison between flat-panel cone-beam CT and CT-scan guidance

Area of Science:

• Medical Imaging
• Interventional Radiology
• Oncology

Background:

• Bone biopsies are crucial for diagnosing bone lesions.
• Conventional computed tomography (CT) guidance is widely used but has limitations.
• Radiation dose is a significant concern for both patients and healthcare professionals during interventional procedures.

Purpose of the Study:

• To compare the accuracy and radiation dose of bone biopsies guided by fluoroscopic guidance with cone-beam CT and real-time 3D image fusion (FP-CBCT-guidance) versus conventional CT-guidance.

Main Methods:

• A prospective study involving 68 patients with bone lesions.
• Bone biopsies were performed using either FP-CBCT-guidance or CT-guidance.
• Technical success, accuracy, puncture time, pathological success rate, and radiation doses (patient and operator) were compared between the two groups.

Main Results:

• Both guidance modalities achieved technical success.
• FP-CBCT-guidance demonstrated significantly better accuracy (3 mm vs. 5 mm).
• Patient radiation doses were substantially lower with FP-CBCT-guidance (45 mSv vs. 136 mSv).
• A lower percentage of operators exceeded the dosimeter detection dose threshold with FP-CBCT-guidance (27% vs. 59%).

Conclusions:

• FP-CBCT-guidance is a highly accurate method for performing bone biopsies.
• This technique significantly reduces radiation exposure for patients and operators compared to conventional CT-guidance.
• FP-CBCT-guidance represents an advancement in interventional radiology for bone lesion biopsies.