Implementing an ultra-low-dose CT protocol during CT-guided percutaneous core needle biopsy (PCNB) can significantly reduce radiation dose while still producing an image quality that is clear enough for biopsy, according to a new study published in the Journal of Vascular and Interventional Radiology.
“CT-guided PCNB has become a major technique for obtaining a definitive pathologic diagnosis before any treatment; however, this diagnostic procedure can potentially expose patients to considerable radiation owing to the repetitive scanning,” wrote Chunhai Li, MD, department of radiology at Qilu Hospital of Shandong University in Shandong Province, China, and colleagues. “Studies have reported that imaging procedures such as CT can result in high cumulative effective doses of radiation in women and children, which may significantly increase lifetime cancer risk.”
To address the potential of high effective radiation doses, the authors studied 210 patients who presented with small pulmonary lesions. Of those patients, 140 were treated with an ultra-low-dose CT protocol (100 kVp with tin filtration) while the other 70 were treated with the standard-dose protocol. All imaging was performed on a third-generation dual-source CT scanner.
Overall, sensitivity was 93.8 percent, specificity was 100 percent and accuracy was 95.4 percent with the ultra-low dose CT protocol. With the standard-dose protocol, those numbers were 95.7 percent, 100 percent and 96.9 percent, respectively. Complication rates did not change significantly.
Effective dose for ultra-low-dose CT protocol was 0.14 mSv, down from 1.78 mSv with the standard-dose protocol. Image quality did dip with the ultra-low-dose CT protocol, but it was still high-quality enough to meet the facility’s requirements.
“The results indicate that although image quality is lower for ultra-low-dose CT, it is comparable with standard-dose CT in both accuracy and safety of PCNB in small pulmonary lesions,” the authors wrote. “Furthermore, ultra-low-dose CT-guided PCNB of lung nodules enables dose reduction of 92.1 percent.”
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