Prospective Randomized Trial for Image-Guided Biopsy Using Cone-Beam CT Navigation Compared with Conventional CT

Area of Science:

• Medical Imaging
• Radiology
• Interventional Procedures

Background:

• Image-guided biopsies are crucial for accurate tissue diagnosis.
• Conventional CT guidance has limitations in precision and radiation exposure.

Purpose of the Study:

• To compare the efficacy and safety of cone-beam CT (CBCT) navigation versus conventional CT (cCT) guidance for biopsies.
• To evaluate differences in accuracy, radiation dose, and diagnostic yield.

Main Methods:

• Prospective randomized trial comparing CBCT navigation and cCT guidance in patients undergoing biopsies.
• Key metrics assessed included needle repositioning, accuracy of needle placement, radiation dose (skin entry and effective dose), and histopathologic diagnosis rate.

Main Results:

• CBCT navigation resulted in significantly fewer needle repositions (0.3 vs 1.9, P < .001) and improved accuracy (4.9 mm vs 12.2 mm, P < .001) compared to cCT.
• CBCT navigation demonstrated a 29% lower average skin entry dose and a 49% lower average effective dose for the planning scan.
• Histopathologic diagnosis rates were comparable between the two groups (93.9% for CBCT vs 90.9% for cCT).

Conclusions:

• Cone-beam CT navigation enhances targeting accuracy and reduces radiation exposure during biopsies.
• It offers a superior alternative to conventional CT guidance, maintaining high diagnostic yield.
• This technology represents a significant advancement in interventional radiology procedures.