Fig. 2. 81-year-old man with colon cancer and hepatic metastasis: true negative case of CBCT virtual navigation-guided percutaneous pleural lesion biopsy.A. Pre-procedural.

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Fig. 2. 81-year-old man with colon cancer and hepatic metastasis: true negative case of CBCT virtual navigation-guided percutaneous pleural lesion biopsy.A. Pre-procedural contrast-enhanced diagnostic CT shows possibility of pleural metastasis involving right lower pleural thickening (arrow) in this patient. B. PET CT performed prior to procedure revealed that this pleural lesion was associated with mild hypermetabolism (arrow). C. Pre-procedural CBCT image shows pleural nodular thickening (arrow). D. Needle entry site, approach technique and needle advance length are determined in pre-procedural CBCT. E.Coaxial introducer needle is introduced into “bull's eye” view of fluoroscopic image, in which skin entry site (pink point) is superimposed onto target (green circle). F. CBCT image shows coaxial introducer needle tip within target. Biopsy was repeated twice and final pathological diagnosis suggested chronic granulomatous inflammation with caseous necrosis (acid-fast bacilli-negative, tuberculosis polymerase chain reaction-positive). Fig. 2. 81-year-old man with colon cancer and hepatic metastasis: true negative case of CBCT virtual navigation-guided percutaneous pleural lesion biopsy.A. Pre-procedural contrast-enhanced diagnostic CT shows possibility of pleural metastasis involving right lower pleural thickening (arrow)… Korean J Radiol. 2018 Sep-Oct;19(5):872-879. https://doi.org/10.3348/kjr.2018.19.5.872