Vladka Salapura
University Clinical Centre Ljubljana, Slovenia
Title: Percutaneous Biopsies of Musculoskeletal Lesions With Xperguide Cone Beam CT-Our Experience
Biography
Biography: Vladka Salapura
Abstract
Purpose: The purpose of our study was to determine feasibility; accuracy and safety of cone-beam CT guided percutaneous biopsies of musculoskeletal system with computer planned needle guidance system. Materials and Methods: Our study included 28 patients who were referred to CT guided percutaneous biopsy of musculoskeletal lesion using cone-beam CT and XperGuide planning system (Allura, Philips) between August 2012 and July 2015 (18 patients from July 2014 were included prospectively). We determined technical and histological success rates. Technical success was defined as needle placement within 5 mm of the target center. Histological success rate was defined as collecting of tissue sample adequate to establish the diagnosis. Complication rate was observed, and sensitivity and specificity for differentiation between malignant and benign lesions were calculated. We measured preparation and procedural time as well as patients’ irradiation dose. Results: Technical success rate was 90%, and histological success rate was 89,3%. The highest histological success rate was observed for lesions in the pelvis and in the lower extremities (p=0,015, Fisher's exact test). We observed no periprocedural complications. Specificity and sensitivity were 100% and 83,3%, respectively. Mean patient preparation time was 49min and mean procedural time was 1h 40min. Mean patient preparation and procedural time was significantly lower for soft-tissue biopsies compared to bone biopsies (p<0,001, Mann Whitney U). Mean effective dose was 13,4mSv. Conclusion: Our findings indicate that computer guided percutaneous biopsy of musculoskeletal lesions using cone-beam CT and XperGuide planning system is a safe and successful diagnostic tool. It can represent a good alternative for standard CT-guided percutaneous biopsies.