Low-dose Protocol for Computed Tomography-guided Lung Biopsy

Lung Cancer, Adenocarcinoma Clinical Trial

Official title:

Low-dose Protocol for Computed Tomography-guided Lung Biopsy

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02971176
• Other study ID #: 20161115-010
• Status: Completed
• Phase: N/A
• Start date: November 30, 2016
• Est. completion date: May 31, 2019

Study information

• Verified date: June 2019
• Source: Xuzhou Central Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to compare the diagnostic accuracy and complication rate between low-dose computed tomography-guided and standard-dose computed tomography-guided lung biopsy.

Description:

With the comprehensive usage of computed tomography examination, patients are more and more aware of the radiation dose of computed tomography. Concerns over the potential for radiation induced malignancies have increasingly been published in the scientific literature and reported in the popular press. The risk is highest for younger patients, who have more radiation-sensitive tissues and longer life expectancies than adults. Recently, the United States Food and Drug Administration announced an initiative to reduce unnecessary radiation exposure from medical imaging. At present, low-dose computed tomography protocol is widely used for the diagnosis of cardiovascular and cerebrovascular diseases.

Computed tomography-guided lung biopsy is widely used for diagnosis of lung nodules and masses. However, it requires repeating scanning to guide the needles, which inevitably increases the radiation dose. Therefore, low-dose protocol was also used in the computed tomography-guided lung biopsy procedure.

The purpose of this study is to compare the diagnostic accuracy and complication rate between low-dose computed tomography-guided and standard-dose computed tomography-guided lung biopsy.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 280
• Est. completion date: May 31, 2019
• Est. primary completion date: May 31, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 90 Years

Eligibility

Inclusion Criteria:

• Non-diagnostic lung lesions; Solid lung lesions; Lesion size = 5mm.

Exclusion Criteria:

• The lesion which has been punctured previously; Severe dysfunction in heart, lung and coagulation function.

Related Conditions & MeSH terms

• Adenocarcinoma
• Adenocarcinoma of Lung
• Lung Cancer, Adenocarcinoma
• Lung Inflammatory Pseudotumor

Intervention

Radiation:
• Low-dose protocol computed tomography
Radiation dose under the low-dose protocol computed tomography (120 kilovolt, 15 milliampere seconds)
• Standard-dose protocol computed tomography
Radiation dose under the standard-dose protocol computed tomography (120 kilovolt, 150 milliampere seconds)

Locations

Country	Name	City	State
China	Xuzhou Central Hospital	Xuzhou	Jiangsu

Sponsors (1)

Lead Sponsor	Collaborator
Xuzhou Central Hospital

Country where clinical trial is conducted

China, 

References & Publications (13)

Adiga S, Athreya S. Safety, efficacy, and feasibility of an ultra-low dose radiation protocol for CT-guided percutaneous needle biopsy of pulmonary lesions: initial experience. Clin Radiol. 2014 Jul;69(7):709-14. doi: 10.1016/j.crad.2014.02.006. Epub 2014 Apr 4. — View Citation

Brenner DJ, Hall EJ. Computed tomography--an increasing source of radiation exposure. N Engl J Med. 2007 Nov 29;357(22):2277-84. Review. — View Citation

Chen GZ, Zhang LJ, Schoepf UJ, Wichmann JL, Milliken CM, Zhou CS, Qi L, Luo S, Lu GM. Radiation dose and image quality of 70 kVp cerebral CT angiography with optimized sinogram-affirmed iterative reconstruction: comparison with 120 kVp cerebral CT angiography. Eur Radiol. 2015 May;25(5):1453-63. doi: 10.1007/s00330-014-3533-y. Epub 2015 Jan 31. — View Citation

Fazel R, Krumholz HM, Wang Y, Ross JS, Chen J, Ting HH, Shah ND, Nasir K, Einstein AJ, Nallamothu BK. Exposure to low-dose ionizing radiation from medical imaging procedures. N Engl J Med. 2009 Aug 27;361(9):849-57. doi: 10.1056/NEJMoa0901249. — View Citation

Gnannt R, Winklehner A, Goetti R, Schmidt B, Kollias S, Alkadhi H. Low kilovoltage CT of the neck with 70 kVp: comparison with a standard protocol. AJNR Am J Neuroradiol. 2012 Jun;33(6):1014-9. doi: 10.3174/ajnr.A2910. Epub 2012 Feb 2. — View Citation

Jaffe TA, Yoshizumi TT, Toncheva G, Anderson-Evans C, Lowry C, Miller CM, Nelson RC, Ravin CE. Radiation dose for body CT protocols: variability of scanners at one institution. AJR Am J Roentgenol. 2009 Oct;193(4):1141-7. doi: 10.2214/AJR.09.2330. — View Citation

Kallianos KG, Elicker BM, Henry TS, Ordovas KG, Nguyen J, Naeger DM. Instituting a Low-dose CT-guided Lung Biopsy Protocol. Acad Radiol. 2016 Sep;23(9):1130-6. doi: 10.1016/j.acra.2016.05.013. Epub 2016 Jun 14. — View Citation

Meng XX, Kuai XP, Dong WH, Jia NY, Liu SY, Xiao XS. Comparison of lung lesion biopsies between low-dose CT-guided and conventional CT-guided techniques. Acta Radiol. 2013 Oct;54(8):909-15. doi: 10.1177/0284185113485937. Epub 2013 Jul 1. — View Citation

Neefjes LA, Dharampal AS, Rossi A, Nieman K, Weustink AC, Dijkshoorn ML, Ten Kate GJ, Dedic A, Papadopoulou SL, van Straten M, Cademartiri F, Krestin GP, de Feyter PJ, Mollet NR. Image quality and radiation exposure using different low-dose scan protocols in dual-source CT coronary angiography: randomized study. Radiology. 2011 Dec;261(3):779-86. doi: 10.1148/radiol.11110606. Epub 2011 Oct 3. — View Citation

Nour-Eldin NE, Alsubhi M, Emam A, Lehnert T, Beeres M, Jacobi V, Gruber-Rouh T, Scholtz JE, Vogl TJ, Naguib NN. Pneumothorax Complicating Coaxial and Non-coaxial CT-Guided Lung Biopsy: Comparative Analysis of Determining Risk Factors and Management of Pneumothorax in a Retrospective Review of 650 Patients. Cardiovasc Intervent Radiol. 2016 Feb;39(2):261-70. doi: 10.1007/s00270-015-1167-3. Epub 2015 Jul 7. — View Citation

Nour-Eldin NE, Alsubhi M, Naguib NN, Lehnert T, Emam A, Beeres M, Bodelle B, Koitka K, Vogl TJ, Jacobi V. Risk factor analysis of pulmonary hemorrhage complicating CT-guided lung biopsy in coaxial and non-coaxial core biopsy techniques in 650 patients. Eur J Radiol. 2014 Oct;83(10):1945-52. doi: 10.1016/j.ejrad.2014.06.023. Epub 2014 Jul 5. — View Citation

Smith JC, Jin DH, Watkins GE, Miller TR, Karst JG, Oyoyo UE. Ultra-low-dose protocol for CT-guided lung biopsies. J Vasc Interv Radiol. 2011 Apr;22(4):431-6. doi: 10.1016/j.jvir.2011.01.431. — View Citation

Zhang LJ, Qi L, De Cecco CN, Zhou CS, Spearman JV, Schoepf UJ, Lu GM. High-pitch coronary CT angiography at 70 kVp with low contrast medium volume: comparison of 80 and 100 kVp high-pitch protocols. Medicine (Baltimore). 2014 Nov;93(22):e92. doi: 10.1097/MD.0000000000000092. — View Citation

* Note: There are 13 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Diagnostic accuracy	Diagnostic accuracy is defined as the biopsy diagnosis matches with the final diagnosis. The final diagnosis is made according to the surgical or follow-up findings.	From the date of randomization until the date of first documented final diagnosis, assessed up to 24 months
Secondary	Complication	Biopsy-related complications mainly include pneumothorax and hemoptysis. Complications is evaluated by computed tomography scan and clinical symptoms.	From the date of randomization until the date of first documented biopsy-related complication, assessed up to 1 day.