Author(s)

Rinpei Imamine^1,2, Hisato Kobayashi², Keizo Akuta², Mitsuru Matsuki³, Hiroyoshi Isoda⁴, Kaori Togashi¹

¹Department of Radiology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
²Department of Radiology, Japanese Red Cross Otsu Hospital, Otsu-shi, Japan.
³Department of Radiology, Kinki University School of Medicine, Sayama-City, Japan.
⁴Preemptive Medicine and Lifestyle-Related Disease Research Center, Kyoto University Hospital, Kyoto, Japan.

Background: Fusion image improves lesion detectability and can be an effective tool for percutaneous ultrasound (US)-guide procedure. We describe the clinical benefit of US-guided lung biopsy using fusion image. Purpose: To retrospectively compare the diagnostic accuracy and complication rates of US-guided lung biopsy with B-mode alone and those of a fusion image created using real-time US and computed tomography (CT). Materials and Methods: Between September, 2013 and September, 2016, 50 peripheral lung lesions in 50 patients (40 males, 10 females; median, 74 years old) were performed by US-guided percutaneous cutting needle biopsy using the B-mode alone or fusion image. Final diagnoses were based on surgical outcomes or clinical follow-up results for at least 12 months after biopsy. To assess prebiopsy characteristics, all lesions were divided into two groups: group 1 (identification on B-mode) and group 2 (identification on fusion image). Results: Of 50 peripheral lesions, 40 lesions (80%) were detected by means of B-mode alone (group 1), and 10 lesions (20%) were identified by fusion image (group 2). The diagnostic accuracy of group 1 was 90% (36/40 lesions), and the diagnostic accuracy of group 2 was 100% (10/10 lesions). Nodule type and the size of the lesions showed significant group wise differences (p < 0.001 and p = 0.02, respectively). Pneumothorax occurred immediately after the first puncture in five of 50 (10%) lesions, with no symptom development in all patients. Conclusion: Fusion images created using real-time US and CT may be useful for identification of the minimal size of potential target lung lesions and may be more suitable for improved yields with US-guided lung biopsy.

Ultrasound, Fusion Image, US-Guided Lung Biopsy, Diagnostic Accuracy, Safety

Imamine, R. , Kobayashi, H. , Akuta, K. , Matsuki, M. , Isoda, H. and Togashi, K. (2019) Diagnostic Accuracy and Complication Rates of Fusion Images Created Using Real-Time Ultrasound with CT for Identification of Peripheral Lung Lesions in Patients Undergoing Biopsy. Open Journal of Radiology, 9, 36-47. doi: 10.4236/ojrad.2019.91004.