Clinical Usefulness of CT-fluoroscopic Lung Biopsy

Abstract

The recent increase in the incidence of “CT-detected lung cancer” demands further development in diagnostic methodology. CT-fluoroscopy is a new device to make visible even a small lesion, for which it has been adopted in performing lung biopsy while observing the lesion in real time.
As this CT-fluoroscopic lung biopsy method could be very useful for diagnosis of “CTdetected lung cancer”, we attempted to determine the merits and limitation of this new technique. In this study percutaneous lung biopsy was performed using a 21G needle while observing the lesion in real time. We estimated the extent of radiological exposure of the operators using a thermoluminescence docimeter (TLD). It was possible to exermine lesions as small as 4mm in diameter. The diagnosis was confirmed by histopathology, in 5 out of 7 cases. Pneumothorax occurred in 4 cases, but none of them required any treatment. We estimated the extent of radiological exposure of the operator's middle finger, back of the hand and forearm. The middle finger was found to be the most exposed part with a maximum exposure value of 34mSV in one case.
It can be concluded that in spite of the small numbers of cases this technique was found to be exceedingly useful for the diagnosis of very small “CT-detected lung cancer”. Another point to be added is that none of the complications required any treatment. The most significant problem with the method was the greater radiological exposure of part of the operator's body, which should be considered carefully in future.