Precision of coaxial needle placement in computed tomography-guided transthoracic needle biopsy

In the present study, a set of self-designed measurement protocols for the precision of coaxial needle placement (PCNP) was proposed and applied in a computed tomography (CT)-guided transthoracic needle biopsy (TNB) audit of an interventional radiologist to determine if the PCNP was commensurate with the experience of the operator. A total of 102 patients (98 with lung lesions and four with mediastinum lesions) consented to be subjected to CT-guided TNB performed by staff interventional radiologists. The patients were divided into two groups based on appointment date. Group A consisted of the first 51 patients and group B comprised of the latter 51 patients. A set of self-designed measurement protocols for PCNP was proposed, and the PCNP was classified into four grades, from grade 1 (most accurate) to grade 4 (least accurate). PCNPs were independently measured by three staff radiologists who were blind to the grouping. The anatomical features of the lesions were also analyzed between the two groups. A significant difference in the PCNP gained after the first needle placement was identified between the two groups (P=0.003, two-tailed). The number of patients in group B with grade I PCNP (51.0%) was significantly higher than that in group A (21.6%) (P<0.05). The number of patients in group B with grade III PCNP (11.8%) was significantly lower than that in group A (29.4%, P<0.05). The PCNP was observed to be commensurate with the experience of the operator and should be considered as a routine audit index in CT guided TNB.