JOURNAL CLUB: Standardizing CT-Guided Biopsy Procedures: Patient Dose and Image Noise

Abstract

Standardization of the image acquisition protocol used in CT-guided biopsy procedures significantly reduced patient radiation dose and decreased variability in image noise.

First experiences of a low-dose protocol for CT-guided musculoskeletal biopsies combining different radiation dose reduction techniques

“…In BiopsyRx, the user can input the longitudinal position of the needle’s insertion location as well as the slice thickness and number of slices required to surround the needle during subsequent CSs. The techniques and RD used on the LightSpeed™ VCT-scanner for MSK biopsies is comparable to that reported in other studies (2, 7–9). A spreadsheet was developed to mimic the functionality of BiopsyRx (since the scanner lacked native software).…”

“…Both the mean total DLP and the CTDI vol values were dramatically lower for protocol A compared to protocol B. While the LightSpeed™ VCT cannot be considered cutting edge, it is important to remember that protocol B resulted in DLP and CTDI vol values that were within the range of RD for CT-guided interventions described in previous studies (2, 7–9).…”

CT‐guided biopsy of breast lesions: When should it be considered?

“…The potential advantages of CT‐guided biopsy versus MRI‐guided biopsy include: a lower cost; faster image acquisition time; a specific coil or biopsy grid is not required; it can be performed in the supine or lateral position, which is often more comfortable for the patient and obviates the need for breast compression; it provides access to lesions located posteriorly to the biopsy grid used in MRI; and it facilitates sedation and patient monitoring. However, there are disadvantages that are associated with CT‐guided biopsy as well, and these include the aforementioned absence of breast compression and exposure to ionizing radiation …”

“…However, there are disadvantages that are associated with CT-guided biopsy as well, and these include the aforementioned absence of breast compression and exposure to ionizing radiation. 10 In conclusion, the cases presented here demonstrate that CT can be a safe and effective alternative imaging modality for the guidance of percutaneous breast biopsy. These cases also support the use of this procedure for suspicious lesions that are not amenable to biopsy…”

Imaging Techniques to Aid IR Treatment of Musculoskeletal Malignancy

“…15 General optimization principles for CT imaging include adapting technical factors to patient size and imaging task. 16 The image reconstruction settings may be configured for the specific imaging task. For MSK interventions, appropriate selection of image thickness, kV, CT reconstruction algorithm (kernel), and window settings are important for optimal visualization.…”