Comparison of Robotic Arm-assisted PET/CT-guided Lung Biopsy With PET Fused CT- Fluoroscopy-guided Lung Biopsy
Condition: Lung Cancer; Lung Diseases; Adenocarcinoma of Lung
MeSH terms: Adenocarcinoma of Lung; Lung Diseases
Study type: Observational

Summary: 
      Patients with suspicious lung lesions were undertaken for PET/CT directed under CT
      fluoroscopy lung biopsy or robotic-assisted biopsy. The biopsy planning including patient
      positioning was done after F18-FDG PET/CT whole body or regional imaging of the patient.
      Written consent was obtained and the patient will be prepared for the biopsy. Lung biopsies
      were done using a semi-automatic biopsy gun under the imaging guidance (PET fused CT
      fluoroscopy) following aseptic precautions. Follow-up CT scans were taken post-biopsy. The
      time consumed for the procedure, radiation exposure to the interventionist, complications and
      diagnostic yield in both the arms were compared.
    

Detailed description: 
      Patients with clinical suspicion of lung lesions were recruited for FDG PET/CT. Based on the
      PET/CT findings and clinical details a PET/CT guided biopsy was planned. The patients were
      assigned to the two arms. In the first arm, participants underwent a robotic-assisted biopsy.
      In the second arm, participants underwent PET/CT-directed CT fluoroscopy-guided lung biopsy.
      The biopsy planning including patient positioning was done after F18-FDG PET/CT whole body or
      regional imaging of the patient. Written consent was obtained and the patient will be
      prepared for the biopsy. Lung biopsies were done using a semi-automatic biopsy gun under the
      imaging guidance (PET fused CT fluoroscopy) following aseptic precautions. Follow-up CT scans
      were taken post-biopsy. The time consumed for the procedure, radiation exposure to the
      interventionist, complications and diagnostic yield in both the arms were compared.
    

Intervention name(s): Robotic arm assisted PET/CT guided biopsy; PET fused CT-Fluoroscopy guided biopsy
Intervention type(s): Procedure; Procedure
Intervention description(s): After preparing the participant for the procedure, the participant was positioned on the PET/CT table with the immobilizer.
An automated robotic arm (MAXIO-EX, Perfint healthcare Pvt Ltd, Chennai, India) was used to guide the needle for biopsy.
Co-axial 18 G biopsy needle (BARD Biopsy disposable coaxial biopsy needle pack, Bard Peripheral Vascular, Inc., Arizona, USA) was inserted according to the orientation planned by the robotic biopsy device.
After the location is ensured, the trocar stylet is removed from the coaxial cannula and specimens were retrieved using a semiautomated biopsy gun.
A repeat CT chest was acquired two hours after the procedure to rule out post-procedural complications.
Complications during the procedure were noted, and immediate management was done.; CT fluoroscopy was used to place the biopsy needle to the FDG avid lung lesion
Observational model: Other
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        The participants attending the pulmonary medicine department with clinical suspicion of
        lung lesions were referred to the Department of Nuclear Medicine for lung biopsies were
        recruited for the study. The participants were randomly assigned to either of the two
        intervention arms. Baseline heart rate, blood pressure, oxygen saturation and respiratory
        system examination were done for all the participants included in the study.