scholarly journals Phantom study for comparison between computed tomography- and C-Arm computed tomography-guided puncture applied by residents in radiology

2021 ◽  
Author(s):  
Timo C. Meine ◽  
Jan B. Hinrichs ◽  
Thomas Werncke ◽  
Saif Afat ◽  
Lorenz Biggemann ◽  
...  
Keyword(s):  
Computed Tomography ◽  
The Self ◽  
Ct Guidance ◽  
Spatial Skills ◽  
Ct Guided ◽  
Needle Path ◽  
Manual Skills ◽  
Level Of Training ◽  
Guided Puncture ◽  
Navigation Software

Purpose Comparison of puncture deviation and puncture duration between computed tomography (CT)- and C-arm CT (CACT)-guided puncture performed by residents in training (RiT). Methods In a cohort of 25 RiTs enrolled in a research training program either CT- or CACT-guided puncture was performed on a phantom. Prior to the experiments, the RiT’s level of training, experience playing a musical instrument, video games, and ball sports, and self-assessed manual skills and spatial skills were recorded. Each RiT performed two punctures. The first puncture was performed with a transaxial or single angulated needle path and the second with a single or double angulated needle path. Puncture deviation and puncture duration were compared between the procedures and were correlated with the self-assessments. Results RiTs in both the CT guidance and CACT guidance groups did not differ with respect to radiologic experience (p = 1), angiographic experience (p = 0.415), and number of ultrasound-guided puncture procedures (p = 0.483), CT-guided puncture procedures (p = 0.934), and CACT-guided puncture procedures (p = 0.466). The puncture duration was significantly longer with CT guidance (without navigation tool) than with CACT guidance with navigation software (p < 0.001). There was no significant difference in the puncture duration between the first and second puncture using CT guidance (p = 0.719). However, in the case of CACT, the second puncture was significantly faster (p = 0.006). Puncture deviations were not different between CT-guided and CACT-guided puncture (p = 0.337) and between the first and second puncture of CT-guided and CACT-guided puncture (CT: p = 0.130; CACT: p = 0.391). The self-assessment of manual skills did not correlate with puncture deviation (p = 0.059) and puncture duration (p = 0.158). The self-assessed spatial skills correlated positively with puncture deviation (p = 0.011) but not with puncture duration (p = 0.541). Conclusion The RiTs achieved a puncture deviation that was clinically adequate with respect to their level of training and did not differ between CT-guided and CACT-guided puncture. The puncture duration was shorter when using CACT. CACT guidance with navigation software support has a potentially steeper learning curve. Spatial skills might accelerate the learning of image-guided puncture. Key Points:  Citation Format

scholarly journals Computed Tomography-Guided Bronchoscopy With an Ultrathin Fiberscope

1996 ◽  
Vol 2 (4) ◽  
pp. 229-232 ◽  
Author(s):  
Toshiaki Kobayashi ◽  
Kayako Shimamura ◽  
Kohzoh Hanai ◽  
Masahiro Kaneko
Keyword(s):  
Computed Tomography ◽  
Pulmonary Function ◽  
Endoscopic Examination ◽  
Open Lung Biopsy ◽  
Ct Guidance ◽  
Ct Guided ◽  
Open Lung ◽  
Examination Method ◽  
The Right ◽  
Poor Pulmonary Function

Bronchoscopy was performed under computed tomography (CT) guidance using an ultrathin fiberscope in a patient with a fluoroscopically invisible lesion that was visualized by CT in the right S8 and with poor pulmonary function. Under local anesthesia, the ultrathin fiberscope (3 mm in diameter) was inserted close to the lesion (1.5 mm in diameter) under direct visual guidance, and a brush was inserted into the lesion under CT guidance. Cytologic specimens obtained by the brush and washing revealed adenocarcinoma. This is the first report of CT-guided bronchoscopy, which is a new examination method for peripheral small lung lesions and is a less invasive examination than either endoscopic examination with a conventional bronchoscope or open lung biopsy, especially for those with poor pulmonary function.

Computed Tomography Guidance for Percutaneous Glycerol Rhizotomy for Trigeminal Neuralgia

2019 ◽  
Vol 19 (2) ◽  
pp. E117-E121
Author(s):  
Bradley T Schmidt ◽  
Conrad D Pun ◽  
Wendell B Lake ◽  
Daniel K Resnick
Keyword(s):  
Computed Tomography ◽  
Trigeminal Neuralgia ◽  
Radiation Exposure ◽  
Skull Base ◽  
Ct Guidance ◽  
Foramen Ovale ◽  
Ct Scanner ◽  
Ct Guided ◽  
Needle Position ◽  
Scout Image

Abstract Background Percutaneous glycerol rhizotomy (PGR) is a well-described treatment for trigeminal neuralgia; however, the technique in using surface landmarks and fluoroscopy has not drastically changed since being first introduced. In this paper, we describe a protocol for PGR using computed tomography (CT) guidance based on an experience of over 7 yr and 200 patients. Objective To introduce an approach for PGR using CT guidance and, in doing so, demonstrate possible benefits over the traditional fluoroscopic technique. Methods Using a standard CT scanner, patients are placed supine with head in extension. Barium paste and a CT scout image are used to identify and plan a trajectory to the foramen ovale. A laser localization system built into the CT scanner helps to guide placement of the spinal needle into the foramen ovale. The needle position in the foramen is confirmed with a short-sequence CT scan. Results CT-guided PGR provides multiple benefits over standard fluoroscopy, including improved visualization of the skull base and significant reduction in radiation exposure to the surgeon and staff. Side benefits include improved procedure efficiency, definitive imaging evidence of correct needle placement, and potentially increased patient safety. We have had no significant complications in over 200 patients. CONCLUSION CT-guided PGR is a useful technique for treating trigeminal neuralgia based on better imaging of the skull base, better efficiency of the procedure, and elimination of radiation exposure for the surgeon and staff compared to traditional fluoroscopic based techniques.

scholarly journals Soft-Tip Stylet and Saline Instillation Technique: Making Difficult Percutaneous CT-Guided Biopsies Possible

2022 ◽  
Author(s):  
Zafar Neyaz
Keyword(s):  
Computed Tomography ◽  
Medical Literature ◽  
Full Potential ◽  
Fatty Tissue ◽  
Ct Guided ◽  
Needle Path ◽  
Guided Biopsy ◽  
Educational Exhibit ◽  
Saline Instillation ◽  
Vital Structure

AbstractFinding a safe needle path during percutaneous computed tomography-guided biopsy is sometimes difficult due to concern for injuring a vital structure. Saline instillation technique has been used to displace the structure out of the way. Another useful tool is a soft-tip stylet. A soft-tip also referred as blunt-tip stylet for the introducer cannula is provided with some coaxial biopsy sets in additional to standard sharp-tip stylet. While the sharp-tip stylet is fitted with introducer cannula for piercing skin, muscle, and fascia, a soft-tip stylet may be used for avoiding injury to structures like vessels and bowel loops especially while advancing introducer cannula through fatty tissue. Additionally, it is also useful for avoiding injury to nerves and giving pleural anesthesia. Although its use has been described in medical literature, many radiologists are still not utilizing this tool to its full potential. In this educational exhibit, various applications of soft-tip stylet and saline instillation technique have been depicted using representative cases.

scholarly journals Role of percutaneous computed tomography-guided radiofrequency ablation in treatment of osteoid osteoma

2017 ◽  
Vol 06 (04) ◽  
pp. 139-140 ◽  
Author(s):  
Ajay R. Upadhyay ◽  
Nikunj Chandrakant Desai ◽  
Digish U. Vaghela
Keyword(s):  
Computed Tomography ◽  
Radiofrequency Ablation ◽  
Success Rate ◽  
Osteoid Osteoma ◽  
Clinical Success ◽  
Tertiary Care ◽  
Ct Guidance ◽  
Western India ◽  
Ct Guided

Abstract Aim: The aim of the study was to evaluate efficacy of percutaneous computed tomography (CT)-guided radiofrequency ablation (RFA) of nidus in osteoid osteoma (OO). Materials and Methods: RFA was performed on fifty patients with clinically and radiologically diagnosed OO. RFA was done in the department of radio-diagnosis in our institute (a tertiary care providing institute in Ahmedabad, Western India). Ablation was performed by putting at an electrode tip (3–5 mm) into nidus under CT guidance with targeted temperature of 90°C for 3 min. Results: All procedures were technically successful. No immediate major or minor complications were observed. Complete clinical success was achieved in 46 patients. Only four patients required second intervention. Conclusion: Our experience indicates a 98% success rate. No major complications were noted.

Computed-tomography-guided punctures using a new guidance device

2005 ◽  
Vol 46 (5) ◽  
pp. 505-509 ◽  
Author(s):  
A. Magnusson ◽  
E. Radecka ◽  
M. Lönnemark ◽  
H. Raland
Keyword(s):  
Computed Tomography ◽  
Entry Point ◽  
Maximum Diameter ◽  
Ct Guided ◽  
New Device ◽  
Needle Path ◽  
Laser Guide ◽  
Pelvic Lesions ◽  
Guidance Device

Purpose: To evaluate a new adjunctive guidance device, a puncture guide, constructed to simplify computed tomography (CT)-guided punctures and to make the procedure more accurate and safe. Material and Methods: 17 patients referred for CT-guided punctures were included in the study. There were 10 thoracic and 7 abdominal or pelvic lesions with a mean maximum diameter of 29±18 mm. All punctures were performed using a laser guide combined with the new device. The needle guide created a streak artefact in the image, indicating the needle path. Results: The puncture was successful at the first attempt in 15 of the 17 patients. The artefact was visible in all patients, and in the majority there was a distinct artefact reaching from the entry point to the lesion. The deviation between the angle of the streak artefact and the final angle of the needle was 1.1°. Conclusion: The benefits of the puncture guide were the artefact pointing at the target, the needle support, and accuracy when performing CT-guided punctures.

Cervical Transforaminal/Nerve Root Injections: Computed Tomography

2016 ◽  
Author(s):  
Tilman Wolter
Keyword(s):  
Computed Tomography ◽  
Nerve Root ◽  
Ct Guidance ◽  
Complication Rates ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Ct Guided ◽  
Real Time Visualization ◽  
Nerve Root Blocks ◽  
Sensitivity Specificity

Computed tomography (CT)–guided selective cervical nerve root blocks, particularly in the dorsal/posterior access, are sensitive, specific, efficacious, and safe. If performed with a lateral/anterolateral access, the CT-fluoroscopic technique with real-time visualization should be chosen. In comparison to fluoroscopy-guided nerve root blocks, CT guidance offers a more precise visualization of the contrast agent. While the advantages of CT guidance seem to outweigh the slightly higher exposure to radiation, this specific topic is debatable and requires additional scientific inquiry. Comparative studies are needed to address the sensitivity, specificity, efficacy, complication rates, and radiation exposure of CT- and fluoroscopy-guided cervical nerve root blocks.

scholarly journals Safety and reliability of computed tomography-guided lipiodol marking for undetectable pulmonary lesions

2020 ◽  
Vol 30 (4) ◽  
pp. 546-551
Author(s):  
Kazuhiro Ito ◽  
Junichi Shimada ◽  
Masanori Shimomura ◽  
Kunihiko Terauchi ◽  
Motohiro Nishimura ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lesion Size ◽  
Ct Guided ◽  
Pulmonary Lesions ◽  
Pleural Surface ◽  
Intraoperative Fluoroscopy ◽  
Safety And Reliability ◽  
Preoperative Ct ◽  
The Mean ◽  
Lipiodol Marking

Abstract OBJECTIVES This study aimed to evaluate the safety and reliability of percutaneous computed tomography (CT)-guided lipiodol marking for undetectable pulmonary lesions before video-assisted thoracic surgery (VATS). METHODS We retrospectively analysed the cases of CT-guided lipiodol marking followed by VATS in 9 institutes from May 2006 to March 2018. Lipiodol (0.2–0.5 ml) was percutaneously injected closely adjacent to undetectable pulmonary lesions with computed-tomography guidance. Lipiodol spots were identified using C-arm-shaped fluoroscopy during VATS. We grasped the lipiodol spots, including the target lesions, with ring-shaped forceps and resected them. RESULTS Of 1182 lesions, 1181 (99.9%) were successfully marked. In 1 case, the injected lipiodol diffused, and no spot was created. Of the 1181 lesions, 1179 (99.8%) were successfully resected with intraoperative fluoroscopy. Two lipiodol spots were not detected because of the lipiodol distribution during the division of pleural adhesions. The mean lesion size was 9.1 mm (range 1–48 mm). The mean distance from the pleural surface was 10.2 mm (range 0–43 mm). Lipiodol marking-induced pneumothorax occurred in 495 (57.1%) of 867 cases. Of these, chest drainage was required in 59 patients (6.8%). The other complications were 19 (2.2%) cases of bloody sputum, 3 (0.35%) cases of intravascular air, 1 (0.12%) case of pneumonia and 1 (0.12%) case of cerebral infarction. There were no lipiodol marking-induced deaths or sequelae. CONCLUSIONS Preoperative CT-guided lipiodol marking followed by VATS resection was shown to be a safe and reliable procedure with a high success rate and acceptably low severe complication rate.

scholarly journals Impact of immediate evaluation of touch imprint cytology from computed tomography guided core needle biopsies of mass lesions: Single institution experience

CytoJournal ◽  
2014 ◽  
Vol 11 ◽  
pp. 15 ◽  
Author(s):  
Mana Moghadamfalahi ◽  
Mirna Podoll ◽  
Amy B. Frey ◽  
Houda Alatassi
Keyword(s):  
Computed Tomography ◽  
Imprint Cytology ◽  
Ct Guided ◽  
Core Needle ◽  
Touch Imprint Cytology ◽  
Effective Manner ◽  
First Pass ◽  
Site Evaluation ◽  
The Impact ◽  
Number Of Passes

Background: Computed tomography (CT) guided core needle biopsy (CT-guided CNB) is a minimally invasive, safe and effective manner of tissue sampling in many organs. The aim of our study is to determine the impact of on-site evaluation of touch imprint cytology (TIC) to minimize the number of passes required to obtain adequate tissue for diagnosis. Design: A retrospective review of all CT-guided CNBs performed during 4 year period, where pathologists were present for on-site TIC evaluation. Each case was evaluated for the number of passes required before TIC was interpreted as adequate for diagnosis. Results: A total of 140 CT-guided CNBs were included in the study (liver, lung, kidney, sacral, paraspinal, omental, splenic and adrenal masses). Of the 140 cases, 109 were diagnosed as malignant, 28 as benign and three insufficient. In 106 cases (75.7%), the biopsies were determined adequate by TIC on the first pass, 19 cases (13%) on the second pass and 7 cases (5%) on the third pass. Only in 5 cases (3.6%), more than three passes were required before diagnostic material was obtained. Three cases (2.14%) were interpreted as inadequate both on TIC and on the final diagnosis. Of the biopsies deemed adequate on the first pass, 71% resulted in either termination of the procedure, or only one additional pass was obtained. In five cases, based on the TIC evaluation, a portion of the sample was sent for either flow cytometric analysis or cytogenetic studies. Conclusions: In the majority of cases, adequate material was obtained in the first pass of CT-guided CNB and once this was obtained, either no additional passes, or one additional pass was performed. This study demonstrates the utility of on-site evaluation in minimizing the number of passes required for obtaining adequate diagnostic material and for proper specimen triage for ancillary studies, which in turn decreases the risk to the patient and costs. However, tumor exhaustion in the tissue as a result of TIC is an important pitfall of the procedure, which occurred in 9 (8.2%) of our malignant cases.

scholarly journals Application of treatment planning system assisted large-aperture computed tomography simulator in percutaneous biopsy: initial experience by a radiation therapist

2020 ◽  
Author(s):  
Xiaoyi Lin ◽  
Jun-qiang Hong ◽  
Shui-ying Luo ◽  
You-qun Lai ◽  
Yong-liang Dai ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Success Rate ◽  
Treatment Planning ◽  
Percutaneous Biopsy ◽  
Lymph Node Biopsy ◽  
Planning System ◽  
Treatment Planning System ◽  
Initial Experience ◽  
Ct Guided ◽  
Large Aperture

Abstract Background and purpose To evaluate the application of treatment planning system (TPS) assisted large-aperture computed tomography (CT) simulator in percutaneous biopsy, and report our initial experience of the accuracy and safety of this procedure.Methods From November 2018 to December 2019, treatment planning system assisted large-aperture CT simulator guided percutaneous biopsy was performed on 38 cases, with 34 of percutaneous lung biopsy, three of abdominal lesions biopsy, and one case of deep supraclavicular lymph node biopsy. The major results including planned and actual puncture parameters, the success rate, pathological information and complications were recorded. The analyses of puncture accuracy were accomplished by pared-t test and Wilcoxon rank sum test. And the risk factors of puncture accuracy and complications were further identified.Results The entire cohort achieved one-time success of biopsy. No significant differences were presented between planned and actual puncture depth and direction (P = 0.436 and 0.382), indicating the precision of the process. And the pulmonary puncture location was related to the accuracy of puncture direction (P = 0.033). Biopsy specimens were successfully obtained in 38 cases. The diagnostic rate of malignancy was 76%, of which 80% for initial treatment group and 69% for treated group, respectively. For patients with pulmonary biopsy, 12 had minor pneumothorax and 2 progressed to massive pneumothorax. Only three cases suffered needle track bleeding, and no other complications were observed. Additionally, the regression analysis found a significant correlation between puncture angle and the incidence of pneumothorax (P = 0.027).Conclusions TPS assisted large-aperture CT simulator improved the procedure of percutaneous biopsy by combining the advantages of radiotherapy specialty. The initial results suggested the increase of puncture accuracy and success rate, with satisfactory safety simultaneously. It might offer new insights into the field of CT-guided percutaneous biopsy.

Sign in / Sign up

Export Citation Format

Share Document