Safety, efficacy, and feasibility of an ultra-low dose radiation protocol for CT-guided percutaneous needle biopsy of pulmonary lesions: Initial experience

AIM: To prospectively determine efficacy and complication rates following an ultra-low dose (ULD) protocol for computed tomography (CT)-guided percutaneous needle biopsy (PNB) of lung lesions. MATERIALS AND METHODS: The use of an ULD protocol (100 kV, 7.5 mAs) for CT-guided lung biopsy was initiated, as a quality assurance initiative. All patients who underwent lung lesion biopsies under ULD were evaluated prospectively. For the purposes of comparison, a retrospective review was conducted to obtain data from patients who underwent the standard-dose protocol for CT-guided PNB of lung lesions. Total dose received, length of procedure, technical success, and complications were evaluated. RESULTS: The overall technical success rate using the ULD protocol was 95.8%. There was a statistically significant 57.5% reduction in radiation dose in the ULD group. There was no significant difference in average length of procedure between the two groups. Complication rates between the two groups were comparable, with 42% in the standard-dose group and 32% in the ULD group; no major complications occurred. Within the ULD group, smaller sized lesions were found to be correlated with higher complication rates, but lesion size had no effect on the total dose of radiation received. CONCLUSION: Radiation dose to the chest during CT-guided lung PNB is reduced significantly by 57.5% through the use of an ULD protocol. Reducing the CT radiation dose does not negatively impact patient safety or biopsy diagnostic rates in PNB. (C) 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.