PMID- 35399565 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220413 IS - 2218-6751 (Print) IS - 2226-4477 (Electronic) IS - 2218-6751 (Linking) VI - 11 IP - 3 DP - 2022 Mar TI - Three-dimensionally printed navigational template: a promising guiding approach for lung biopsy. PG - 393-403 LID - 10.21037/tlcr-22-172 [doi] AB - BACKGROUND: Percutaneous transthoracic lung biopsy is customarily conducted under computed tomography (CT) guidance, which primarily depends on the conductors' experience and inevitably contributes to long procedural duration and radiation exposure. Novel technique facilitating lung biopsy is currently demanded. METHODS: Based on the reconstructed anatomical information of CT scans, a three-dimensionally printed navigational template was customized to guide fine-needle aspiration (FNA). The needle insertion site and angle could be indicated by the template after proper placement according to the reference landmarks. From June 2020 to August 2020, patients with peripheral indeterminate lung lesions >/=30 mm in diameter were enrolled in a pilot trial. Cases were considered successful when the virtual line indicated by the template in the first CT scan was pointing at the target, and the rate of success was recorded. The insertion deviation, procedural duration, radiation exposure, biopsy-related complications, and diagnostic yield were documented as well. RESULTS: A total of 20 patients consented to participate, and 2 withdrew. The remaining 18 participants consisting of 11 men and 7 women with a median age of 63 [inter-quartile range (IQR), 50-68] years and a median body mass index (BMI) of 23.5 (IQR, 20.8-25.8) kg/m(2) received template-guided FNA. The median nodule size of the patients was 41.2 (IQR, 36.2-51.9) mm and 17 lesions were successfully targeted (success rate, 94.4%). One lesion was not reached through the designed trajectory due to an unpredictable alteration of the lesion's location resulting from pleural effusion. The median deviation between the actual position of the needle tip and the designed route was 9.4 (IQR, 6.8-11.7) mm. The median procedural duration was 10.7 (IQR, 9.7-11.8) min, and the median radiation exposure was 220.9 (IQR, 198.6-249.5) mGyxcm. No major biopsy-related complication was encountered. Definitive diagnosis of malignancy was reached in 13 of the 17 (76.5%) participants. CONCLUSIONS: The feasibility and safety of navigational template-guided FNA were preliminarily validated in lung biopsy cohort. Nonetheless, patients with pleural effusion were not recommended to undergo FNA guided by such technique. TRIAL REGISTRATION: This study was registered with ClinicalTrials.gov (identifier: NCT03325907). CI - 2022 Translational Lung Cancer Research. All rights reserved. FAU - E, Haoran AU - E H AD - Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China. FAU - Chen, Jiafei AU - Chen J AD - Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China. FAU - Sun, Weiyan AU - Sun W AD - Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China. FAU - Zhang, Yikai AU - Zhang Y AD - School of Information Science and Technology, ShanghaiTech University, Shanghai, China. FAU - Ren, Shengxiang AU - Ren S AD - Department of Medical Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China. FAU - Shi, Jingyun AU - Shi J AD - Department of Radiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China. FAU - Wen, Yaofeng AU - Wen Y AD - Lanhui Medical Technology Co., Ltd., Shanghai, China. FAU - Su, Chunxia AU - Su C AD - Department of Medical Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China. FAU - Ni, Jian AU - Ni J AD - Department of Medical Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China. FAU - Zhang, Lei AU - Zhang L AD - Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China. FAU - He, Yayi AU - He Y AD - Department of Medical Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China. FAU - Chen, Bin AU - Chen B AD - Department of Medical Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China. FAU - Casal, Roberto F AU - Casal RF AD - Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. FAU - Kheir, Fayez AU - Kheir F AD - Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. FAU - Ishiwata, Tsukasa AU - Ishiwata T AD - Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada. FAU - Zhang, Jie AU - Zhang J AD - Department of Medical Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China. FAU - Zhao, Deping AU - Zhao D AD - Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China. FAU - Chen, Chang AU - Chen C AD - Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China. AD - The International Science and Technology Cooperation Base for Development and Application of Key Technologies in Thoracic Surgery, Lanzhou, China. AD - Department of Thoracic Surgery, The First Hospital of Lanzhou University, Lanzhou, China. AD - The Province's Famous Expert Workstation, The First People's Hospital of Linhai, Taizhou, China. LA - eng SI - ClinicalTrials.gov/NCT03325907 PT - Journal Article PL - China TA - Transl Lung Cancer Res JT - Translational lung cancer research JID - 101646875 PMC - PMC8988075 OTO - NOTNLM OT - Lung biopsy OT - computed tomography (CT) OT - fine-needle aspiration (FNA) OT - three-dimensional printing (3D printing) COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tlcr.amegroups.com/article/view/10.21037/tlcr-22-172/coif). YW is a current employee of Lanhui Medical Technology Co., Ltd. The other authors have no conflicts of interest to declare. EDAT- 2022/04/12 06:00 MHDA- 2022/04/12 06:01 PMCR- 2022/03/01 CRDT- 2022/04/11 05:14 PHST- 2021/12/16 00:00 [received] PHST- 2022/03/18 00:00 [accepted] PHST- 2022/04/11 05:14 [entrez] PHST- 2022/04/12 06:00 [pubmed] PHST- 2022/04/12 06:01 [medline] PHST- 2022/03/01 00:00 [pmc-release] AID - tlcr-11-03-393 [pii] AID - 10.21037/tlcr-22-172 [doi] PST - ppublish SO - Transl Lung Cancer Res. 2022 Mar;11(3):393-403. doi: 10.21037/tlcr-22-172.