ArticleFrontiers in oncology2025
Active breathing coordinator combines with custom-designed puncture needle improves diagnostic accuracy of ≤20 mm pulmonary nodules under CT-guidance: a real world prospective study.
Article in Frontiers in oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
Background: CT-guided percutaneous transthoracic needle biopsy (PTNB) is still the main way for obtaining pathological diagnoses of pulmonary nodules. However, the small size and respiratory-induced motion reduce diagnostic accuracy for patients with small pulmonary nodules (≤20mm). In this study, we aimed to improve biopsy precision and diagnostic accuracy for patients with small pulmonary nodules via introducing significant refinements. Methods: 122 patients with ≤20mm pulmonary nodules were enrolled and randomly assigned to the ABC-NG PTNB group and CT-guided PTNB group. The CT-guided PTNB group underwent conventional CT-guided PTNB, while the ABC-NG PTNB group received additional ways including thermoplastic immobilization, active breathing coordinator (ABC), and a custom-designed puncture needle. Puncture accuracy, diagnostic accuracy, and complication rates were compared between the two groups. Results: The ABC-NG PTNB group was superior to the CT-guided PTNB group in the terms of angle error, craniocaudal plane error, positioning error, diagnostic accuracy, and one-puncture success rate (P < 0.05). The ABC-NG PTNB group had fewer punctures, fewer CT scans, lower radiation doses, and lower incidence of pneumothorax as compared to CT-guided PTNB group (P < 0.05). Furthermore, diagnostic accuracy was particularly enhanced in cases where the puncture angle was non-zero or when the nodules were located in the lower lung lobes (P < 0.05). Conclusion: Ct-guided PTNB combined with ABC and custom-designed puncture needle guide improves the accuracy and diagnosis rate of ≤20mm pulmonary nodule biopsy, especially nodules are located in the lower lung lobe or require a non-zero puncture angle.
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