Comput. Aided Surg. - Accuracy and diagnostic yield of CT-guided stereotactic liver biopsy of primary and secondary liver tumors.

Tópicos

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Resumo

JECTIVE: CT-guided biopsy still plays a decisive role in the management of liver tumors, especially if the lesions are not visible or accessible by ultrasound. As CT-guided stereotaxy appears to be a very accurate targeting technique, the aim of this study was to evaluate the targeting accuracy, diagnostic yield, and complications of CT-guided stereotactic liver biopsy of primary and secondary liver tumors.METHODS AND MATERIALS: Prior to stereotactic liver biopsy, patients under general anesthesia were immobilized using a vacuum cushion. Respiratory motion was controlled by temporary disconnections of the endotracheal tube. An optical-based navigation system was used for 3D trajectory planning and placement of a 15-G coaxial needle via a stereotactic aiming device. The histological samples were obtained using a 16-G Tru-Cut(?) biopsy needle system. For evaluation of targeting accuracy the control CT image with the needles in place was fused with the planning CT image. The lateral error at the tip and skin entry point and the angular error were calculated. In addition, the skin-to-liver-surface (SL) distance, the needle-to-liver-surface (NL) angle, and the presence of liver cirrhosis were evaluated. The diagnostic yield was evaluated by histological reports from the institutional pathologists.RESULTS: The median lateral error was 2.5 mm (range: 0-6.5 mm) at the needle entry point and 3.2 mm (range: 0.01-9.4 mm) at the needle tip. The median angular error was 1.06? (range: 0-6.64?). Liver cirrhosis, NL angle and SL distance showed no significant impact on the targeting accuracy. Forty-five of the 46 liver biopsies (97.8%) were diagnostic according to the histological reports. No puncture-related complications such as bleeding or perforation of intestinal organs or lung tissue were recorded.

Resumo Limpo

jectiv ctguid biopsi still play decis role manag liver tumor especi lesion visibl access ultrasound ctguid stereotaxi appear accur target techniqu aim studi evalu target accuraci diagnost yield complic ctguid stereotact liver biopsi primari secondari liver tumorsmethod materi prior stereotact liver biopsi patient general anesthesia immobil use vacuum cushion respiratori motion control temporari disconnect endotrach tube opticalbas navig system use d trajectori plan placement g coaxial needl via stereotact aim devic histolog sampl obtain use g trucut biopsi needl system evalu target accuraci control ct imag needl place fuse plan ct imag later error tip skin entri point angular error calcul addit skintoliversurfac sl distanc needletoliversurfac nl angl presenc liver cirrhosi evalu diagnost yield evalu histolog report institut pathologistsresult median later error mm rang mm needl entri point mm rang mm needl tip median angular error rang liver cirrhosi nl angl sl distanc show signific impact target accuraci fortyf liver biopsi diagnost accord histolog report puncturerel complic bleed perfor intestin organ lung tissu record

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