Comparison of low- and standard-dose CT-guided transthoracic core needle biopsies: Feasibility, safety, diagnostic yield, and radiation dose

Abstract

Background: Computed tomography (CT)-guided transthoracic biopsy is essential for diagnosing pulmonary lesions butexposes patients to considerable radiation from repeated image acquisitions. With the growing emphasis on radiationsafety, applying validated low-dose CT protocols to interventional procedures has become a key clinical priority.Purpose: To assess the feasibility, safety, diagnostic yield, and radiation dose of low-dose computed tomography-guidedtransthoracic biopsies using an 80 kVp protocol compared with standard 120 kVp protocols.Methods: A retrospective review was performed on 183 consecutive computed tomography-guided transthoracic bi-opsies of lung nodules or masses, including 143 procedures with the standard 120 kVp protocol and 40 procedures with alow-dose 80 kVp protocol at 30 mAs. Procedural characteristics, image quality, histopathological adequacy, radiationexposure, and complications were analyzed. Both subjective and objective image quality assessments, including signal-to-noise and contrast-to-noise ratios, and cellular analyses of specimens were compared.Results: The low-dose protocol reduced mean effective radiation dose from 5.89 ± 2.88 millisieverts to 0.19 ±0.06 millisieverts, a 96.8% reduction. Biopsy specimen adequacy was 85% in the low-dose group versus 79% in the standard-dose group. Complication rates were comparable, 45% versus 43.4%. Subjective image quality was lower in the low-dosegroup, but objective signal-to-noise and contrast-to-noise ratios remained sufficient for accurate diagnosis.Conclusion: Computed tomography-guided transthoracic biopsies with an 80 kVp and 30 mAs protocol significantlyreduce radiation exposure without compromising diagnostic yield or safety. This low-dose approach is a viable alternativeto conventional protocols and can be adopted in routine interventional radiology practice.