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Fong KY, Tan ASM, Bin Sulaiman MS, Leong SH, Ng KW, Too CW. Phantom and Animal Study of a Robot-Assisted, CT-Guided Targeting System using Image-Only Navigation for Stereotactic Needle Insertion without Positional Sensors. J Vasc Interv Radiol 2022; 33:1416-1423.e4. [PMID: 35970505 DOI: 10.1016/j.jvir.2022.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/11/2022] [Accepted: 08/05/2022] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To evaluate the feasibility and accuracy of a robotic system to integrate and map computed tomography (CT) and robotic coordinates, followed by automatic trajectory execution by a robotic arm. The system was hypothesized to achieve a targeting error of <5 mm without significant influence from variations in angulation or depth. MATERIALS AND METHODS An experimental study was conducted using a robotic system (Automated Needle Targeting device for CT [ANT-C]) for needle insertions into a phantom model on both moving patient table and moving gantry CT scanners. Eight spherical markers were registered as targets for 90 insertions at different trajectories. After a single ANT-C registration, the closed-loop software targeted multiple markers via the insertion of robotically aligned 18-gauge needles. Accuracy (distance from the needle tip to the target) was assessed by postinsertion CT scans. Similar procedures were repeated to guide 10 needle insertions into a porcine lung. A regression analysis was performed to test the effect of needle angulation and insertion depth on the accuracy of insertion. RESULTS In the phantom model, all needle insertions (median trajectory depth, 64.8 mm; range, 46.1-153 mm) were successfully performed in single attempts. The overall accuracy was 1.36 mm ± 0.53, which did not differ between the 2 types of CT scanners (1.39 mm ± 0.54 [moving patient table CT] vs 1.33 mm ± 0.52 [moving gantry CT]; P = .54) and was not significantly affected by the needle angulation and insertion depth. The accuracy for the porcine model was 9.09 mm ± 4.21. CONCLUSIONS Robot-assisted needle insertion using the ANT-C robotic device was feasible and accurate for targeting multiple markers in a phantom model.
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Affiliation(s)
- Khi Yung Fong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Alexander Sheng Ming Tan
- Department of Vascular and Interventional Radiology, Singapore General Hospital, Singapore; Radiological Sciences Academic Clinical Program, SingHealth-Duke-NUS Academic Medical Centre, Singapore
| | | | | | - Ka Wei Ng
- NDR Medical Technology Pvt Ltd, Singapore
| | - Chow Wei Too
- Department of Vascular and Interventional Radiology, Singapore General Hospital, Singapore; Radiological Sciences Academic Clinical Program, SingHealth-Duke-NUS Academic Medical Centre, Singapore.
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Wang Z, Lv Y, He S, Zhao Z, Wang N. A newly developed image fusion algorithm between CECT image and CT image: A feasibility study. Proc Inst Mech Eng H 2022; 236:1646-1653. [DOI: 10.1177/09544119221129917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cancer cases have been on the rise over the world. Cancer treatment can benefit from an early accurate diagnosis. Percutaneous needle biopsy under the guidance of CT images is the most common method to obtain tumor samples for accurate diagnosis. However, due to the lack of vascular information in the CT images, the biopsy procedure is at great risk, especially for the tumor surrounded by vessels. In this study, a biomechanical model and surface elastic registration-based fusion algorithm were developed to map the vessels from contrast-enhanced CT images of the liver and lung to the corresponded CT image. Radiologists could observe vessels in the CT images during the biopsy procedure so that the risk can be decreased. The developed algorithm was tested through 20 groups of lung data and 16 groups of liver data. The results show that the fusion errors (mean ± standard deviation) were 2.35 ± 0.85, 2.08 ± 0.41, 2.31 ± 0.49, and 2.37 ± 0.62 mm for portal vein, hepatic vein, pulmonary artery, and pulmonary vein, respectively. The accuracy of this method was satisfied in clinical application
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Affiliation(s)
- Zi Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yinzhang Lv
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shaowen He
- Wuhan United-imaging Surgical Technology Company, Ltd, Wuhan, Hubei, China
| | - Zhuo Zhao
- Wuhan United-imaging Surgical Technology Company, Ltd, Wuhan, Hubei, China
| | - Nan Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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3
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Abrishami Kashani M, Campbell-Washburn AE, Murphy MC, Catalano OA, McDermott S, Fintelmann FJ. Magnetic Resonance Imaging for Guidance and Follow-up of Thoracic Needle Biopsies and Thermal Ablations. J Thorac Imaging 2022; 37:201-216. [PMID: 35426857 PMCID: PMC10441002 DOI: 10.1097/rti.0000000000000651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Magnetic resonance imaging (MRI) is used for the guidance and follow-up of percutaneous minimally invasive interventions in many body parts. In the thorax, computed tomography (CT) is currently the most used imaging modality for the guidance and follow-up of needle biopsies and thermal ablations. Compared with CT, MRI provides excellent soft tissue contrast, lacks ionizing radiation, and allows functional imaging. The role of MRI is limited in the thorax due to the low hydrogen proton density and many air-tissue interfaces of the lung, as well as respiratory and cardiac motion. Here, we review the current experience of MR-guided thoracic needle biopsies and of MR-guided thermal ablations targeting lesions in the lung, mediastinum, and the chest wall. We provide an overview of MR-compatible biopsy needles and ablation devices. We detail relevant MRI sequences and their relative advantages and disadvantages for procedural guidance, assessment of complications, and long-term follow-up. We compare the advantages and disadvantages of CT and MR for thoracic interventions and identify areas in need of improvement and additional research.
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Affiliation(s)
| | - Adrienne E Campbell-Washburn
- Division of Intramural Research, Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Mark C Murphy
- Division of Thoracic Imaging and Intervention, Department of Radiology
| | - Onofrio A Catalano
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA
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Gilbert FJ, Harris S, Miles KA, Weir-McCall JR, Qureshi NR, Rintoul RC, Dizdarevic S, Pike L, Sinclair D, Shah A, Eaton R, Clegg A, Benedetto V, Hill JE, Cook A, Tzelis D, Vale L, Brindle L, Madden J, Cozens K, Little LA, Eichhorst K, Moate P, McClement C, Peebles C, Banerjee A, Han S, Poon FW, Groves AM, Kurban L, Frew AJ, Callister ME, Crosbie P, Gleeson FV, Karunasaagarar K, Kankam O, George S. Dynamic contrast-enhanced CT compared with positron emission tomography CT to characterise solitary pulmonary nodules: the SPUtNIk diagnostic accuracy study and economic modelling. Health Technol Assess 2022; 26:1-180. [PMID: 35289267 DOI: 10.3310/wcei8321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Current pathways recommend positron emission tomography-computerised tomography for the characterisation of solitary pulmonary nodules. Dynamic contrast-enhanced computerised tomography may be a more cost-effective approach. OBJECTIVES To determine the diagnostic performances of dynamic contrast-enhanced computerised tomography and positron emission tomography-computerised tomography in the NHS for solitary pulmonary nodules. Systematic reviews and a health economic evaluation contributed to the decision-analytic modelling to assess the likely costs and health outcomes resulting from incorporation of dynamic contrast-enhanced computerised tomography into management strategies. DESIGN Multicentre comparative accuracy trial. SETTING Secondary or tertiary outpatient settings at 16 hospitals in the UK. PARTICIPANTS Participants with solitary pulmonary nodules of ≥ 8 mm and of ≤ 30 mm in size with no malignancy in the previous 2 years were included. INTERVENTIONS Baseline positron emission tomography-computerised tomography and dynamic contrast-enhanced computer tomography with 2 years' follow-up. MAIN OUTCOME MEASURES Primary outcome measures were sensitivity, specificity and diagnostic accuracy for positron emission tomography-computerised tomography and dynamic contrast-enhanced computerised tomography. Incremental cost-effectiveness ratios compared management strategies that used dynamic contrast-enhanced computerised tomography with management strategies that did not use dynamic contrast-enhanced computerised tomography. RESULTS A total of 380 patients were recruited (median age 69 years). Of 312 patients with matched dynamic contrast-enhanced computer tomography and positron emission tomography-computerised tomography examinations, 191 (61%) were cancer patients. The sensitivity, specificity and diagnostic accuracy for positron emission tomography-computerised tomography and dynamic contrast-enhanced computer tomography were 72.8% (95% confidence interval 66.1% to 78.6%), 81.8% (95% confidence interval 74.0% to 87.7%), 76.3% (95% confidence interval 71.3% to 80.7%) and 95.3% (95% confidence interval 91.3% to 97.5%), 29.8% (95% confidence interval 22.3% to 38.4%) and 69.9% (95% confidence interval 64.6% to 74.7%), respectively. Exploratory modelling showed that maximum standardised uptake values had the best diagnostic accuracy, with an area under the curve of 0.87, which increased to 0.90 if combined with dynamic contrast-enhanced computerised tomography peak enhancement. The economic analysis showed that, over 24 months, dynamic contrast-enhanced computerised tomography was less costly (£3305, 95% confidence interval £2952 to £3746) than positron emission tomography-computerised tomography (£4013, 95% confidence interval £3673 to £4498) or a strategy combining the two tests (£4058, 95% confidence interval £3702 to £4547). Positron emission tomography-computerised tomography led to more patients with malignant nodules being correctly managed, 0.44 on average (95% confidence interval 0.39 to 0.49), compared with 0.40 (95% confidence interval 0.35 to 0.45); using both tests further increased this (0.47, 95% confidence interval 0.42 to 0.51). LIMITATIONS The high prevalence of malignancy in nodules observed in this trial, compared with that observed in nodules identified within screening programmes, limits the generalisation of the current results to nodules identified by screening. CONCLUSIONS Findings from this research indicate that positron emission tomography-computerised tomography is more accurate than dynamic contrast-enhanced computerised tomography for the characterisation of solitary pulmonary nodules. A combination of maximum standardised uptake value and peak enhancement had the highest accuracy with a small increase in costs. Findings from this research also indicate that a combined positron emission tomography-dynamic contrast-enhanced computerised tomography approach with a slightly higher willingness to pay to avoid missing small cancers or to avoid a 'watch and wait' policy may be an approach to consider. FUTURE WORK Integration of the dynamic contrast-enhanced component into the positron emission tomography-computerised tomography examination and the feasibility of dynamic contrast-enhanced computerised tomography at lung screening for the characterisation of solitary pulmonary nodules should be explored, together with a lower radiation dose protocol. STUDY REGISTRATION This study is registered as PROSPERO CRD42018112215 and CRD42019124299, and the trial is registered as ISRCTN30784948 and ClinicalTrials.gov NCT02013063. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 17. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Fiona J Gilbert
- Department of Radiology, University of Cambridge School of Clinical Medicine, Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Scott Harris
- Public Health Sciences and Medical Statistics, University of Southampton, Southampton, UK
| | - Kenneth A Miles
- Department of Radiology, University of Cambridge School of Clinical Medicine, Biomedical Research Centre, University of Cambridge, Cambridge, UK
- Department of Radiology, Royal Papworth Hospital, Cambridge, UK
| | - Jonathan R Weir-McCall
- Department of Radiology, University of Cambridge School of Clinical Medicine, Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Nagmi R Qureshi
- Department of Radiology, Royal Papworth Hospital, Cambridge, UK
| | - Robert C Rintoul
- Department of Thoracic Oncology, Royal Papworth Hospital, Cambridge, UK
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - Sabina Dizdarevic
- Departments of Imaging and Nuclear Medicine and Respiratory Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
- Brighton and Sussex Medical School, Brighton, UK
| | - Lucy Pike
- King's College London and Guy's and St Thomas' PET Centre, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Donald Sinclair
- King's College London and Guy's and St Thomas' PET Centre, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Andrew Shah
- Radiation Protection Department, East and North Hertfordshire NHS Trust, Stevenage, UK
| | - Rosemary Eaton
- Radiation Protection Department, East and North Hertfordshire NHS Trust, Stevenage, UK
| | - Andrew Clegg
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Valerio Benedetto
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - James E Hill
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Andrew Cook
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Dimitrios Tzelis
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Luke Vale
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Lucy Brindle
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Jackie Madden
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Kelly Cozens
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Louisa A Little
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Kathrin Eichhorst
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Patricia Moate
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Chris McClement
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Charles Peebles
- Department of Radiology and Respiratory Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Anindo Banerjee
- Department of Radiology and Respiratory Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sai Han
- West of Scotland PET Centre, Gartnavel Hospital, Glasgow, UK
| | - Fat Wui Poon
- West of Scotland PET Centre, Gartnavel Hospital, Glasgow, UK
| | - Ashley M Groves
- Institute of Nuclear Medicine, University College London, London, UK
| | - Lutfi Kurban
- Department of Radiology, Aberdeen Royal Hospitals NHS Trust, Aberdeen, UK
| | - Anthony J Frew
- Departments of Imaging and Nuclear Medicine and Respiratory Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
- Brighton and Sussex Medical School, Brighton, UK
| | - Matthew E Callister
- Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Philip Crosbie
- North West Lung Centre, University Hospital of South Manchester, Manchester, UK
| | - Fergus V Gleeson
- Department of Radiology, Churchill Hospital, Oxford, UK
- University of Oxford, Oxford, UK
| | | | - Osei Kankam
- Department of Thoracic Medicine, East Sussex Healthcare NHS Trust, Saint Leonards-on-Sea, UK
| | - Steve George
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
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Matsui Y, Hiraki T, Sakurai J, Okamoto S, Iguchi T, Tomita K, Uka M, Yamauchi T, Gobara H, Kanazawa S. Percutaneous needle biopsy under 1.2 Tesla open MRI guidance. Jpn J Radiol 2021; 40:430-438. [PMID: 34739653 DOI: 10.1007/s11604-021-01211-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/21/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the feasibility of percutaneous needle biopsy using a 1.2 Tesla open magnetic resonance imaging (MRI) system, which has the highest field strength among the currently available open MRI systems. MATERIALS AND METHODS This single-center prospective study included 10 patients. The primary endpoint was the feasibility of biopsy needle insertion into a target lesion under 1.2 Tesla open MRI guidance. The secondary endpoints included adverse events, device failures, and success of tissue specimen acquisition. Biopsy was performed for targets in various organs using an MRI-compatible coaxial needle system consisting of a 16G introducer needle and 18G semi-automatic biopsy needle. A newly developed body coil with a suitable design for intervention was used for intraprocedural imaging. RESULTS Biopsy procedures were performed for six musculoskeletal masses, two retroperitoneal masses, one renal mass, and one liver mass. The median diameter of the targets was 4.9 cm (range 2.1-22.8 cm). MRI-guided biopsy needle insertion was feasible in all 10 patients. In total, four grade 1 adverse events (as per Common Terminology Criteria for Adverse Events version 4.0) occurred in three patients. Adequate biopsy specimens for pathological diagnosis were successfully obtained from all 10 patients. CONCLUSION Percutaneous needle biopsy using a 1.2 Tesla open MRI system was feasible for relatively large targets, especially in the musculoskeletal region.
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Affiliation(s)
- Yusuke Matsui
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Takao Hiraki
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Jun Sakurai
- Center for Innovative Clinical Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan
| | - Soichiro Okamoto
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Toshihiro Iguchi
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Koji Tomita
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Mayu Uka
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Takatsugu Yamauchi
- Central Division of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan
| | - Hideo Gobara
- Division of Medical Informatics, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan
| | - Susumu Kanazawa
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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MRI Image Segmentation Model with Support Vector Machine Algorithm in Diagnosis of Solitary Pulmonary Nodule. CONTRAST MEDIA & MOLECULAR IMAGING 2021; 2021:9668836. [PMID: 34377105 PMCID: PMC8318753 DOI: 10.1155/2021/9668836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/12/2021] [Indexed: 12/02/2022]
Abstract
This study focused on the application value of MRI images processed by a Support Vector Machine (SVM) algorithm-based model in diagnosis of benign and malignant solitary pulmonary nodule (SPN). The SVM algorithm was constrained by a self-paced regularization item and gradient value to establish the MRI image segmentation model (SVM-L) for lung. Its performance was compared factoring into the Dice index (DI), sensitivity (SE), specificity (SP), and Mean Square Error (MSE). 28 SPN patients who underwent the parallel MRI examination were selected as research subjects and were divided into the benign group (11 patients) and malignant group (17 patients) according to different plans for diagnosis and treatment. The apparent diffusion coefficient (ADC) at different b values was analyzed, and the steepest slope (SS) and washout ratio (WR) values in the two groups were calculated. The result showed that the MSE, DI, SE, SP values, and operation time of the SVM-L model were (0.41 ± 0.02), (0.84 ± 0.13), (0.89 ± 0.04), (0.993 ± 0.004), and (30.69 ± 2.60)s, respectively, apparently superior to those of the other algorithms, but there were no statistic differences (P > 0.05) in the WR value between the two groups of patients. The SS values of the time-signal curve in the benign and malignant groups were (2.52 ± 0.69) %/s and (3.34 ± 00.41) %/s, respectively. Obviously, the SS value of the benign group was significantly lower than that of the malignant group (P < 0.01). The ADC value with different b values in the benign group was significantly lower than that of the malignant group (P < 0.01). It suggested that the SVM-L model significantly improved the quality of lung MRI images and increased the accuracy to differentiate benign and malignant SPN, providing reference for the diagnosis and treatment of SPN patients.
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Li CL, Yan XC, Liu M, Li PP, Guo XT, Xu YJ, He XM. Magnetic resonance-guided repeat biopsy of suspicious malignant lung lesions after an initial negative computed tomography-guided Biopsy. J Cancer Res Ther 2021; 17:1689-1695. [DOI: 10.4103/jcrt.jcrt_1655_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Wang J, Song Y, Liu J, Meng X, Xing Z, Zhang M, Ye F, Wang X, Wang X. Clinical Application and Feasibility of MRI-Guided Breast Biopsy of Breast Minimal Lesions in Chinese Population. Front Oncol 2020; 10:257. [PMID: 32211320 PMCID: PMC7067823 DOI: 10.3389/fonc.2020.00257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 02/14/2020] [Indexed: 12/16/2022] Open
Abstract
Objectives: Some breast lesions are not visible on mammography or ultrasonography, and magnetic resonance imaging (MRI) become the only way to monitor these lesions. The purpose of this study was to evaluate the clinical application of MRI-guided biopsy and MRI-guided wire localization of breast minimal lesions in Chinese population. Methods: We evaluated 95 patients (the most patients of known in China) from August 2013 to December 2017. All the patients were scanned with a 1.5-Tesla MRI system (GE Medical Systems, America) in the prone position using a bilateral 8-channel phased-array breast coil and underwent MRI-guided wire localization or MRI-guided biopsy. Results: MRI-guided wire localization and MRI-guided biopsy were successfully performed in 87 patients with 88 lesions (100%, 88/88). After biopsy or surgery, 36 of 88 lesions (40.91%) were malignant, and 52 of 88 lesions (59.09%) were benign. Thirty-nine of 88 lesions (44.32%) were masses, and 49 of 88 (55.68%) showed non-mass enhancement. Statistical analysis showed there was no significant correlation between the malignancy rate and the type of lesion on MRI (P = 0.27). In this study, the rate of malignancy for Breast Imaging-Reporting and Data System (BI-RADS) 5 lesions was 100% (2 of 2) compared with 44.44% for BI-RADS 4C lesions (4 of 9), 42.42% for BI-RADS 4B lesions (14 of 33), and 36.36% for BI-RADS 4A lesions (16 of 44). Conclusions: MRI-guided wire localization with subsequent surgical biopsy and MRI-guided biopsy are safe and effective tools for breast minimal lesions.
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Affiliation(s)
- Jie Wang
- Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Song
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiaqi Liu
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangzhi Meng
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zeyu Xing
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Menglu Zhang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Ye
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiang Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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9
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Zhang F, Wang J, Guo J, Li Y, Huang X, Guan Z, Lei G, Wang J, Ye X, Zhao X, Wang J, Wang R, Liu B. Chinese Expert Consensus Workshop Report: Guideline for permanent iodine-125 seed implantation of primary and metastatic lung tumors. Thorac Cancer 2019; 10:388-394. [PMID: 30521144 PMCID: PMC6360234 DOI: 10.1111/1759-7714.12912] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/11/2018] [Indexed: 12/20/2022] Open
Abstract
Surgery remains the first choice of cure for early stage lung cancer. However, many patients are diagnosed at advanced stage, and thus miss the opportunity to undergo surgery. As such patients derive limited benefits from chemotherapy or radiotherapy, alternatives focusing on local control have emerged, including iodine-125 seed implantation. The Interstitial Brachytherapy Society, Committee of Minimally Invasive Therapy in Oncology, Chinese Anti-Cancer Association organized a group of multidisciplinary experts to develop guidelines for this treatment modality. These guidelines aim to standardize iodine-125 seed implantation procedures, inclusion criteria, and outcome assessment to prevent and manage procedure-related complications.
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Affiliation(s)
- Fujun Zhang
- Imaging and Interventional CenterSun Yat‐sen University Cancer CenterGuangzhouChina
| | - Junjie Wang
- Department of Radiation Oncology, Cancer CentrePeking University Third HospitalBeijingChina
| | - Jinhe Guo
- Department of RadiologySoutheast University, Zhongda HospitalNanjingChina
| | - Yuliang Li
- Department of Interventional MedicineThe Second Hospital of Shandong UniversityJinanChina
- Interventional Oncology Institute of Shandong UniversityJinanChina
| | - Xuequan Huang
- Department of Interventional MedicineThe First Hospital Affiliated to AMU (Southeast Hospital)ChongqingChina
| | - Zhiyu Guan
- Department of Thoracic SurgeryThe Second Hospital of Tianjin Medical UniversityTianjinChina
| | - Guangyan Lei
- Department of Thoracic SurgeryShaanxi Provincial Cancer HospitalXi'anChina
| | - Juan Wang
- Department of OncologyHebei General HospitalShijiazhuangChina
| | - Xin Ye
- Department of OncologyShandong Provincial Hospital Affiliated to Shandong UniversityJinanChina
| | - Xiaogang Zhao
- Department of Thoracic SurgeryThe Second Hospital of Shandong UniversityJinanChina
| | - Jing Wang
- Department of RespirationShandong Provincial Hospital Affiliated to Shandong UniversityJinanChina
| | - Ruoyu Wang
- Department of OncologyThe Affiliated Zhongshan Hospital of Dalian UniversityDalianChina
| | - Bin Liu
- Department of Interventional MedicineThe Second Hospital of Shandong UniversityJinanChina
- Interventional Oncology Institute of Shandong UniversityJinanChina
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Guo Z, Shi H, Li W, Lin D, Wang C, Liu C, Yuan M, Wu X, Xiong B, He X, Duan F, Han J, Yang X, Yu H, Si T, Xu L, Xing W, Jinhua H, Wang Y, Xie H, Cui L, Gao W, He D, Liu C, Liu Z, Ma C, Pan J, Shao H, Tu Q, Yong L, Xu Y, Weihao Z, Qiang Z, Wang S. Chinese multidisciplinary expert consensus: Guidelines on percutaneous transthoracic needle biopsy. Thorac Cancer 2018; 9:1530-1543. [PMID: 30221455 PMCID: PMC6209790 DOI: 10.1111/1759-7714.12849] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 07/25/2018] [Indexed: 12/14/2022] Open
Abstract
Biopsy has been used to diagnose thoracic diseases for more than a century. Percutaneous needle biopsy plays a crucial role in the diagnosis, staging, and treatment planning for tumors in the lungs, thoracic wall, hilum, and mediastinum. With the continuous improvement in imaging techniques, the range of clinical applications for percutaneous needle biopsy is also expanding. It has become important to improve Chinese professionals’ and technicians’ understanding of percutaneous transthoracic needle biopsy (PTNB) in order to standardize operating procedures and to strengthen perioperative management. However, there is currently no Chinese expert consensus that provides systematic standardization and guidance for PTNB in clinical practice. The Committee of Chinese Society of Interventional Oncology (CSIO) of the Chinese Anti‐Cancer Association (CACA) initiated a Chinese multidisciplinary expert consensus on PTNB. The consensus includes image‐guided methods, indications, contraindications, multidisciplinary team recommendations, biopsy procedures, daytime/outpatient biopsy, complications, pathological examination, and management of negative results.
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Affiliation(s)
- Zhi Guo
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Committee of Chinese Society of Interventional Oncology, China Anti-Cancer Association, Tianjin, China
| | - Hong Shi
- Chinese Medical Association Publishing House, Beijing, China
| | - Wentao Li
- Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Dongmei Lin
- Department of Pathology, Peking University Cancer Hospital, Beijing, China
| | - Changli Wang
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Chen Liu
- Department of Pathology, Peking University Cancer Hospital, Beijing, China
| | - Min Yuan
- Department of Interventional Radiology, Shanghai Public Health Clinical Center, Shanghai, China
| | - Xia Wu
- Department of Interventional Radiology, Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Bin Xiong
- Department of Interventional Radiology, Huazhong University of Science and Technology Affiliated with Union Hospital of Tongji Medical College, Wuhan, China
| | - Xinhong He
- Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Feng Duan
- Department of Interventional Therapy, The General Hospital of People's Liberation Army, Beijing, China
| | - Jianjun Han
- Department of Interventional Therapy, Shandong Cancer Hospital, Jinan, China
| | - Xueling Yang
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Haipeng Yu
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Tongguo Si
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Linfeng Xu
- Department of Interventional Therapy, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Wenge Xing
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Huang Jinhua
- Department of Interventional Therapy, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Yingjuan Wang
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Hui Xie
- Department of Interventional Therapy, 302 Military Hospital of China, Beijing, China
| | - Li Cui
- Department of Interventional Therapy, The General Hospital of People's Liberation Army, Beijing, China
| | - Wei Gao
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Dongfeng He
- The Affiliated Cancer Hospital of Harbin Medical University, Harbin, China
| | - Changfu Liu
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Zhou Liu
- Department of Interventional Therapy, Shenzhen Cancer Hospital, Shenzhen, China
| | - Chunhua Ma
- Department of Interventional Therapy, Tianjin Huanhu Hospital, Tianjin, China
| | - Jie Pan
- Department of Interventional Therapy, Peking Union Medical College Hospital, Beijing, China
| | - Haibo Shao
- Department of Interventional Therapy, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Qiang Tu
- Department of Interventional Therapy, Jiangxi Cancer Hospital, Nanchang, China
| | - Li Yong
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Yan Xu
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Zhang Weihao
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Zou Qiang
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Sen Wang
- Department of Interventional Therapy, Tianjin Third Central Hospital, Tianjin, China
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11
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Liu C, Wang L, He X, Xu Y, Lu D, Li P, Lv R, Feng Y, Liu M, Li C. 1.0T MR-guided percutaneous coaxial cutting needle biopsy in pancreatic lesion diagnosis. J Magn Reson Imaging 2018; 48:382-388. [PMID: 29319916 DOI: 10.1002/jmri.25952] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 12/21/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Pancreatic carcinoma is a common cause of cancer deaths worldwide. Biopsy is often required for the initial diagnosis of pancreatic masses. Biopsy can be performed endoscopically or percutaneously with computed tomography (CT) and ultrasound (US) guidance. MRI offers many inherent advantages over CT and US. PURPOSE/HYPOTHESIS To prospectively evaluate the feasibility, accuracy, and safety of MRI-guided percutaneous coaxial cutting needle biopsy of pancreatic lesions using an open 1.0T high-field MR scanner. STUDY TYPE Prospective. POPULATION Thirty-one patients with 31 pancreatic lesions underwent MR-guided percutaneous coaxial cutting needle biopsy. FIELD STRENGTH/SEQUENCE 1.0T T2 WI-TSE PDW-aTSE T1 WI-TFE. ASSESSMENT Final diagnosis was confirmed by surgery and clinical follow-up for at least 12 months. The accuracy, sensitivity, and specificity were calculated. Complications were recorded. STATISTICAL TESTS There was no statistical analysis in this study. RESULTS The procedure was technically successful and final biopsy samples were adequate for histopathological examination in all patients. Biopsy pathology revealed malignant pancreatic tumor in 25 patients (25/31, 80.6%), and benign pancreatic lesions were present in six patients (6/31, 19.4%). The final diagnosis was pancreatic malignancy in 27 patients and benign disease in four patients, which was confirmed by surgery and clinical follow-up. Two biopsy results were false-negative. The diagnostic accuracy in biopsies was 93.5% (29 of 31). The sensitivity to detect a malignant disease was 92.6% (25 of 27), and the specificity was 100%. All patients tolerated the procedure well; minor peripancreatic hemorrhage was found in two patients after the procedure, and none had major complications either during or after the procedure. DATA CONCLUSION MRI-guided percutaneous biopsy of pancreatic lesions using an open 1.0T high-field scanner has high diagnostic accuracy, which is feasible and safe for use in clinical practice. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2018;48:382-388.
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Affiliation(s)
- Chao Liu
- Department of Minimally Invasive Tumor, Tai'an Central Hospital, Tai'an, Shandong, P.R. China
| | - Ligang Wang
- Department of Interventional Therapy, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, P.R. China
| | - Xiangmeng He
- Department of Interventional MRI, Shandong Medical Imaging Research Institute affiliated to Shandong University, Jinan, Shandong, P.R. China
| | - Yujun Xu
- Department of Interventional MRI, Shandong Medical Imaging Research Institute affiliated to Shandong University, Jinan, Shandong, P.R. China
| | - Dong Lu
- Department of Interventional Radiology, Affiliated Anhui Provincial Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Peipei Li
- Department of Oncology, Liaocheng Tumor Hospital, Liaocheng, Shandong, P.R. China
| | - Rongbin Lv
- Department of Nuclear Medicine, Tai'an Central Hospital, Tai'an, Shandong, P.R. China
| | - Yong Feng
- Department of Minimally Invasive Tumor, Tai'an Central Hospital, Tai'an, Shandong, P.R. China
| | - Ming Liu
- Department of Interventional MRI, Shandong Medical Imaging Research Institute affiliated to Shandong University, Jinan, Shandong, P.R. China
| | - Chengli Li
- Department of Interventional MRI, Shandong Medical Imaging Research Institute affiliated to Shandong University, Jinan, Shandong, P.R. China
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