Benefits and Safety of CT Fluoroscopy in Interventional Radiologic Procedures

Carlson, Stephanie K.; Bender, Claire E.; Classic, Kelly; Zink, Frank E.; Quam, Jeffrey P.; Ward, Ellen MacDonald; Oberg, Ann L.

doi:10.1148/radiology.219.2.r01ma41515

Cited by 181 publications

(83 citation statements)

References 9 publications

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“…In the CBCT system, 3D image data transferring and reconstruction time after CT are added to the total procedure time with 1 or 2 min usually spent during the change from the fluoroscopic mode to the 3D CT acquisition mode. However, the total coaxial introducer dwell time in our study was only 8.7±3.8 min (range 4-22 min), which was less than that of PCNB under CT fluoroscopy guidance (10.9±8.2 min) [4] and much less than that under conventional sequential CT guidance (median 30 min) [12,13]. The conservation of needle dwell time under CBCT guidance was thought to be due to the accurate and fast targeting ability under the realtime fluoroscopy capability of CBCT and the decreased number of needle repositionings needed with this system.…”

Section: Discussioncontrasting

confidence: 63%

Initial experience of percutaneous transthoracic needle biopsy of lung nodules using C-arm cone-beam CT systems

et al. 2010

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Section: Discussioncontrasting

confidence: 63%

Initial experience of percutaneous transthoracic needle biopsy of lung nodules using C-arm cone-beam CT systems

et al. 2010

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“…Due to the wide availability of CT, this imaging technique remains the modality of choice for guidance in many interventional procedures [14]. CT-guided biopsies with an angled biopsy path can only be acquired by using the triangulation method which should be performed by experienced radiologists only, because the continuous monitoring of the instruments is limited due to the gantry gyration [15].…”

Section: Discussionmentioning

confidence: 99%

MR-guided biopsies of lesions in the retroperitoneal space: technique and results

et al. 2005

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The purpose of this study was to evaluate the safety and precision of MRI-guided biopsies of retroperitoneal space-occupying tumors in an open low-field system. In 30 patients with indistinct retroperitoneal tumors [paraaortic lesion (n=20), kidney (n=2), suprarenal gland (n=3) and pancreas (n=5)] MR-guided biopsies were performed using a low-field system (0.2 T, Magnetom Concerto, Siemens, Germany). For the monitoring of the biopsies T1-weighted FLASH sequences (TR/TE=160/5 ms; 90 degrees ) were used in all patients and modified FLASH sequences (TR/TE=160/13 ms; 90 degrees ) in ten patients. After positioning of the needle in the tumors 114 biopsy specimens were acquired in coaxial technique with 16-gauge cutting needles (Somatex, Germany). The biopsies were successfully performed in all patients without vascular or organ injuries. The visualization of the aortic blood flow with MRI facilitated the biopsy procedures of paraaortic lesions. The size of the lesions ranged from 1.6 to 7.5 cm. The median distance of the biopsy access path was 10.4 cm. Adequate specimens were obtained in 28 cases (93.3%) resulting in a correct histological classification of 27 lesions (90%). In conclusion, MR-guided biopsies of retroperitoneal lesions using an open low-field system can be performed safely and accurately and is an alternative to CT-guided biopsies.

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“…CTF provides real-time guidance of the biopsy needle, decreases procedure time and requires fewer needle passes than CT-guided procedures without fluoroscopic guidance [2][3][4][5][6]. CTF has furthermore been shown to significantly reduce radiation doses to the patients, but it exposes the radiologist to radiation, as the operator is in the room at the time [7,8]. We have used the CTF-technique for thoracic interventions in our daily routine for several years.…”

Section: Introductionmentioning

confidence: 99%

Accuracy and complications in computed tomography fluoroscopy-guided needle biopsies of lung masses

2006

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The aim of this study was to determine the diagnostic accuracy and frequency of complications of lung biopsy procedures with or without CTF guidance of needle insertion. Records and images of 99 consecutive percutaneous coaxial cutting needle lung biopsy procedures performed on 85 patients were reviewed retrospectively. Fifty-seven and 42 procedures had been done with and without CTF guidance, respectively. Histological results were compared to diagnosis after surgery or after a follow-up period of 12 months. Diagnostic accuracy and the occurrence of pneumothorax and/or bleeding related to the procedures were registered. The level of accuracy of the diagnosis was comparable. The diagnostic accuracy was 96% (50/52) and 95% (34/36) sensitivity 95% (35/37) and 93% (26/28), specificity 100% (15/15) and 100% (8/8) with CTF and conventional CT techniques, respectively. There were fewer post procedure pneumothoraces using the CTF than conventional technique [26% (15/57) vs. 38% (16/42)], but the difference was not statistically significant (P = 0.274). The insertion of a chest tube was required in only one (2%) procedure using the CTF technique, while this was needed in four (10%) using the conventional technique. Small or large hemorrhages occurred in 23% of the procedures, with no apparent difference between the two groups. In conclusion, CTF-guided biopsy of lung lesions provides high diagnostic accuracy, comparable to that of conventional CT-guided procedures, with a low rate of complications, even for small tumors.

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Benefits and Safety of CT Fluoroscopy in Interventional Radiologic Procedures

Abstract: As implemented at the authors' institution, use of CT fluoroscopy for the guidance of interventional radiologic procedures markedly decreased patient radiation dose and total procedure time compared with use of conventional CT guidance.

Cited by 181 publications

References 9 publications

Initial experience of percutaneous transthoracic needle biopsy of lung nodules using C-arm cone-beam CT systems

Initial experience of percutaneous transthoracic needle biopsy of lung nodules using C-arm cone-beam CT systems

MR-guided biopsies of lesions in the retroperitoneal space: technique and results

Accuracy and complications in computed tomography fluoroscopy-guided needle biopsies of lung masses

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