The Primary Study Of Application Of C-arm CT In Lung Biopsy And Radiofrequency Ablation Of Lung Nodules

ObjectiveTo retrospectively analyze the application of C-arm CT in two methods of lung biopsy and radiofrequency ablation of lung nodules,and to explore the primary clincal applicational value of C-arm CT in lung biopsy and radiofrequency ablation of lung nodules.Materials and methodsThe 57 cases (56 patients) of lung biopsy of lung nodules were divided into two groups according to the method: traditional method group and improved method group,then compared the positive rate ,the rate of complication and radiation dose between two groups of lung biopsy ,and to analyze the factors which influencing the positive rate ,the complication rate.At the same time,we analyzed the postoperative accumulated survival rate,the response rate and the complication rate of radiofrequency ablation of lung nodules.Results1.The total postive rate of lung biopsy was 78.9%.The postive rate of traditional method group and improved method group was respectively 69.4%(25/36),95.2%(20/21).The postive rate of improved method group was higher than traditional method group.The postive rate was significantly different between the two groups(p=0.049).The mean accumulated dose and mean effective dose of traditional method group was respectively 81.33±59.51mGy,2.41±1.85mSv,and the improved method group was respectively 124.24±63.99mGy,3.56±1.85mSv.The accumulated dose and effective dose of improved method group were higher than traditional method group.The accumulated dose and effective dose were significantly different between the two groups.2.All the cases were grouped according to the biopsy methods,the size of lesions,the puncture depth,the location of leisions ,then compared the complication rate between groups .When all the cases was grouped according to the biopsy methods,the positive rate was different between two group.Binary logistic regression analysis demonstrated that biopsy methods were the factor which may influence the positive rate.3.All the cases were grouped according to the biopsy methods,the size of lesions,the puncture depth,the location of leisions ,then compared the complication rate between groups .When all the cases was grouped according to the puncture depth,the complication rate was different between two group.Binary logistic regression analysis demonstrated that the puncture depth were the factor which may influence the complication rate.4.There are 16 cases(18 foci of 15 patients) of radiofrequency ablation of lung nodules.The success rate of pancture was 100% in 18 foci.12 cases had complications,including pneumothorax in 2(all were not requiring aspiration or thoracic closed drainage),hemoptysis in 2 ,and chest pain in 7.The accumulated survival rate at 6 month,1 year ,2 year was respectively 100.0%,66.0%,66.0%.In the first assessment of 15 foci which had imaging record during the follow-up period,the total response rate is 53.33%(8/15).The mean accumulated dose and mean effective dose of radiofrequency ablation of lung nodules was respectively 187.62±108.46 mGy,5.50±3.31 mSv,which were higher than traditional method group and improved method group of lung biopsy.Conclusion1.C-arm CT is the result of integration of a number of informational systems,which can simplify and improve traditional diagnostic and therapeutic process,bring operator rich information of guiding of puncture and monitoring and evaluation of operation,sharply increase the accuracy of lung biopsy and the success rate of radiofrequency ablation of lung nodules.It has important clinical application value。2.When under the guidance of C-arm CT to perform lung biopsy and radiofrequency ablation of lung nodules,we should try to decrease operation-related radiation dosage and the complication rate on the basis of ensuring successful puncture.