Computed Tomography-Navigation™ Electromagnetic System Compared to Conventional Computed Tomography Guidance for Percutaneous Lung Biopsy: A Single-Center Experience

Abstract

The aim of our study was to assess the efficacy of a computed tomography (CT)-Navigation™ electromagnetic system compared to conventional CT methods for percutaneous lung biopsies (PLB). In this single-center retrospective study, data of a CT-Navigation™ system guided PLB (NAV-group) and conventional CT PLB (CT-group) performed between January 2017 and February 2020 were reviewed. The primary endpoint was the diagnostic success. Secondary endpoints were technical success, total procedure duration, number of CT acquisitions and the dose length product (DLP) during step ∆1 (from planning to initial needle placement), step ∆2 (progression to target), and the entire intervention (from planning to final control) and complications. Additional parameters were recorded, such as the lesion’s size and trajectory angles. Sixty patients were included in each group. The lesions median size and median values of the two trajectory angles were significantly lower (20 vs. 29.5 mm, p = 0.006) and higher in the NAV-group (15.5° and 10° vs. 6° and 1°; p < 0.01), respectively. Technical and diagnostic success rates were similar in both groups, respectively 95% and 93.3% in the NAV-group, and 93.3% and 91.6% in the CT-group. There was no significant difference in total procedure duration (p = 0.487) and total number of CT acquisitions (p = 0.066), but the DLP was significantly lower in the NAV-group (p < 0.01). There was no significant difference in complication rate. For PLB, CT-Navigation™ system is efficient and safe as compared to the conventional CT method.

Computed Tomography–guided Percutaneous Lung Biopsy With Electromagnetic Navigation Compared With Conventional Approaches

“…However, there was no significant difference in surgical time or the number of CT scans between the 2 groups 18 . Another retrospective nonrandomized study reported that technical and diagnostic success rates, total procedure duration, total CT acquisitions and complication rates were similar between the CT-EM navigation system–guided percutaneous lung biopsies and the conventional CT guidance, but the radiation dose was significantly reduced with EM navigation 19 …”

“…18 Another retrospective nonrandomized study reported that technical and diagnostic success rates, total procedure duration, total CT acquisitions and complication rates were similar between the CT-EM navigation system-guided percutaneous lung biopsies and the conventional CT guidance, but the radiation dose was significantly reduced with EM navigation. 19 To further investigate the clinical value of EM navigation systems, we performed this prospective clinical study. The results from our trial suggest that compared with conventional approaches, CT-guided percutaneous lung biopsy with EM navigation is helpful for reducing the number of needle adjustments.…”

Navigation and Robotics in Interventional Oncology: Current Status and Future Roadmap

“…The feasibility and safety of the robotic-assisted insertion of biopsy introducer needles have been assessed with a variety of systems in a spectrum of studies, including different target locations [ 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ]. Biopsy sessions were feasible in all patients with accurate needle targeting of the lesion [ 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ].…”

“…The feasibility and safety of the robotic-assisted insertion of biopsy introducer needles have been assessed with a variety of systems in a spectrum of studies, including different target locations [ 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ]. Biopsy sessions were feasible in all patients with accurate needle targeting of the lesion [ 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ]. The performance of a robotic system for CT-guided lung biopsy in comparison to the conventional manual technique was evaluated in a study of 100 patients, which showed that robot-assisted CT-guided lung biopsy was safe, with high diagnostic accuracy, and reduced procedure times and radiation doses in comparison to the conventional freehand technique.…”