AUTHORS:
D.C. Gianfelice, MD, L. Lepanto, MD, P. Perreault, MD, C. Chartrand, MD.
ABSTRACT:
PURPOSE: To assess the clinical impact of CTF with respect to facilitating CT guided procedures.
METHOD AND MATERIALS: 201 consecutive procedures performed by the same interventional radiologist under CTF guidance(123m;78f:mean age 60.2 yrs).Variety of interventions including thoracic(N=70) and abdominal/miscellaneous(N=131). Control group of 100 consecutive classical CT-guided procedures also performed by the same radiologist in the 5 months preceeding the study(60m;40f:mean age 63.7 yrs).Procedures in control group included thoracic(N=30) and abdominal/misc.(N=70) Total procedure time, successful tissue retieval and complication rates were documented in both groups.
RESULTS: Overall tissue retrieval rate was increased in the CTF vs control group(94%vs89%) with increased tissue retrieval in both thoracic(CTF 93%; control 90%) and abdominal/misc(CTF 94.6%; control 88.6%) subgroups. Complication rates were comparable(7.5%) and consisted mainly of pneumothoraces following lung biopsy. A statistically significant difference was noted in overall procedure time between the two groups(CTF 27.4 min/patient; control 42.6 min/patient: Pr 0.0001) CTF especially helpful in difficult interventions including the mobile pulmonary nodule, the small pulmonary nodule, mediastinal masses,pancreatic lesions and thoracic vertebral lesions.CTF also allows complex procedures to be performed faster with less chance of complication i.e alcohol tumor ablation, sympatholysis.
CONCLUSIONS: CTF offers opportunity to perform interventions quicker while increasing tissue yield as opposed to classical CT-guided methods. Visualisation of needle trajectory allows more aggressive biopsy stategies using larger core biopsy needles hence harvesting more tissue for analysis. This technology may eventually allow transfer of some classical fluoroscopic procedures into the CT suite and may alleviate the "fear" factor for radiologists with little interventional procedure experience.
