|
Objective:
Through this article we share our initial experience in doing
lung biopsies with automated biopsy planner / guidance machine,
thereby comparing the diagnostic accuracy and technical difficulties
using both manual and automated planning.
Materials and methods:
Seventy two consecutive CT-guided lung biopsies were done.
Of these 36 biopsies were done using manual planning and same
number using an automated guidance apparatus. All were performed
by trained radiologists in a double blinded manner. Accuracy,
technical difficulties and complications using both methods
were analyzed.
| |
Manual
|
Automated
|
p-value
|
|
Median
|
Range
|
Median
|
Range
|
| No.of Entries |
3
|
2-4
|
1
|
1-2
|
0.00*
|
| Time Consumed |
55
|
30-90
|
30
|
20-50
|
0.00*
|
| No.of check scans |
4
|
3 - 4
|
1
|
1-2
|
0.00*
|
| Complication Rate (%)* |
8 (44.4)
|
3 (16.7)
|
0.15 î
|
| Yield Rate (%) |
11 (61.1)
|
12 (66.7)
|
1.00 î
|
Results:
The mean lesion size was 3.5 cm (range, 1.8- 11.5 cm). The
mean number of needle repositioning was 1.3 with automated
guidance and 2.9 using manual planning (p=0.00 Mann-Whitney
U test). Twenty five biopsies (69.4%) yielded sufficient tissue
for pathologic evaluation using automated comparing 23(63.8%)
by manual method (p=1.00, Chi-square). Average number of check
scans was significantly lower (p=0.00 Mann-Whitney U test)
in automated (1.3) than in manual planning (3.6). Total duration
of time taken for completion of a procedure is also notably
reduced (p=0.00 Mann-Whitney U test) while doing with automated
(30.8min) than with manual planning (58.7 min).The difference
in complication rate using manual (44.4%) and automated (16.7%)
methods was not statistically significant(p=0.15, Chi-square)
Conclusion:
Both manual and automated planning offered comparable accuracy
in getting sufficient tissue for pathologic evaluation and
statistically equal incidence of complications. Automated
planning scores over manual planning in terms of technical
difficulty, number of needle passes, time consumed, number
of check scans and hence the patient's radiation dosage.
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