Prospective randomized trial comparing cone-beam CT (CBCT) navigation vs. conventional CT for biopsies

Purpose To compare conventional CT image guidance vs. cone-Beam CT navigation (Xperguide) for biopsies. Materials and Methods The study is prospective randomized trial approved by Institutional Board Review. All patients scheduled for CT guided biopsies in interventional radiology with lesions deeper than 3cm were eligible. Exclusion criteria included ultrasound guidance, superficial lesion, and inability to consent. The number of needle repositioning, time to target, and clinical success were examined. Needle repositioning was defined as any pullback of the needle to re-orient its direction. Clinical success was defined as adequate histopathological specimen enabling diagnosis. The time to target was defined as the time elapsed between the initial scans and specimen. Radiation dose was measured by optical stimulated luminescent dosimeters. The number of verification CT or CBCT was also noted. Results Currently, results are available for 36 patients (26 men, 10 females) having undergone 39 procedures (22 Xperguide vs. 17 CT). Eighteen lung, 6 retroperitoneum lesions, 15 kidney biopsies were performed. The number of needle repositioning with Xperguide was 0.36 vs. 2.05 with CT (p Conclusion Preliminary results from this prospective randomized trial indicate that CBCT navigation might reduce number of manipulations and radiation required to reach target however the time to target remains unchanged.