Abstract 875: Comparison of Real-Time CT Fluoroscopy versus Conventional CT Guidance in Nonvascular Interventional Procedures
AUTHORS:
V. Spies, MD, J. Link, MD, M. Strotzer, MD, W.R. Nitz, PhD, C. Altjohann, MD, S.G.
ABSTRACT:
PURPOSE: To evaluate the usefulness of CT fluoroscopy for nonvascular interventional procedures regarding procedure time, radiation dose and success rate in comparison with conventional CT guidance.
MATERIALS AND METHODS: In this prospective randomized study, a total of seventy interventional procedures were performed using CT guidance: CT-fluoroscopy was used in 32 procedures: 17 drainage catheters, 11 biopsies and 4 gastrostomy tube insertions; Conventional CT guidance was used in 35 procedures: 17 drainage catheters, 15 biopsies and 3 gastrostomy tube insertions. In 3 cases both guidance modalities were used. Procedure time, radiation dose (CTDI-Index)and success rate were analyzed separately by using the Mann-Whitney-Rank-Sum-Test.
RESULTS: All drainage catheters (n=34) were inserted successfully using both modalities (CT-fluoroscopy and conventional CT guidance). There was no significant difference regarding procedure time (mean values: 22.71 min versus 24.47 min; p=0.756). Using CT-fluoroscopy, radiation dose was more than twice the dose applied with conventional CT (mean values of the CTDI-Index: 313 versus 147.53; p=0.003). 10 biopsies using CT-fluoroscopy and 13 biopsies using conventional CT showed representative histo-pathological results. Analysis of procedure time showed no significant difference (mean values: 23.36 min versus 19.47 min; p=0.285). The radiation dose using CT-fluoroscopy was three times higher than using conventional CT (mean values of the CTDI-Index: 398.64 versus 130.80; p0.06).
CONCLUSION: CT-fluoroscopy guidance is more comfortable than conventional CT guidance in nonvascular interventional procedures, but results in much higher radiation exposure values. There is no significant difference between both modalities regarding procedure time. CT-fluoroscopy might be useful in difficult approaches.
