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KMID : 0880420190200050844
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Korean Journal of Radiology
2019 Volume.20 No. 5 p.844 ~ p.853
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Learning Curve of C-Arm Cone-beam Computed Tomography Virtual Navigation-Guided Percutaneous Transthoracic Needle Biopsy
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Ahn Su-Yeon
Park Chang-Min
Yoon Soon-Ho
Kim Hyung-Jin
Goo Jin-Mo
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Abstract
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Objective: To evaluate the learning curve for C-arm cone-beam computed tomography (CBCT) virtual navigation-guided percutaneous transthoracic needle biopsy (PTNB) and to determine the amount of experience needed to develop appropriate skills for this procedure using cumulative summation (CUSUM).
Materials and Methods: We retrospectively reviewed 2042 CBCT virtual navigation-guided PTNBs performed by 7 novice operators between March 2011 and December 2014. Learning curves for CBCT virtual navigation-guided PTNB with respect to its diagnostic performance and the occurrence of biopsy-related pneumothorax were analyzed using standard and risk-adjusted CUSUM (RA-CUSUM). Acceptable failure rates were determined as 0.06 for diagnostic failure and 0.25 for PTNB-related pneumothorax.
Results: Standard CUSUM indicated that 6 of the 7 operators achieved an acceptable diagnostic failure rate after a median of 105 PTNB procedures (95% confidence interval [CI], 14?240), and 6 of the operators achieved acceptable pneumothorax occurrence rate after a median of 79 PTNB procedures (95% CI, 27?155). RA-CUSUM showed that 93 (95% CI, 39?142) and 80 (95% CI, 38?127) PTNB procedures were required to achieve acceptable diagnostic performance and pneumothorax occurrence, respectively.
Conclusion: The novice operators' skills in performing CBCT virtual navigation-guided PTNBs improved with increasing experience over a wide range of learning periods.
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KEYWORD
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Learning curve, Lung, Percutaneous needle biopsy, Cone-beam CT
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