Percutaneous abdominopelvic interventional procedures using real-time CT fluoroscopy guidance at 21 mAs: an analysis of 99 consecutive cases

Objective: The purpose of our study was to retrospectively evaluate the efficacy, the limitations and the complications of real-time CT fluoroscopy (Carevision) as an adjunct to CT guidance for percutaneous abdominopelvic interventional procedures. Materials and methods. During a 28 month period, 99 patients (55 men, 44 women) with a mean age of 59 years had percutaneous abdominopelvic interventional procedure under CT guidance using CT fluoroscopy. Sixty-four patients had a percutaneous drainage of an abdominopelvic fluid collection with a Seldinger technique using an 8.5- to 14-F drainage catheter and 35 patients had a percutaneous biopsy using an 18-G automatic core biopsy needle.

Results: In all cases, the quality of the real-time CT fluoroscopic images allowed to securely monitor needle advancement towards the target lesion and to confirm correct position of the needle tip. The diameters of target lesions ranged from 1.5 to 10 cm, with a mean value of 4.75 cm. No immediate complications were observed. The real-time CT fluoroscopy times ranged from 25 to 242 sec, with a mean time of 117 sec. All percutaneous procedures (100%) were successfully performed.

Conclusions: Our initial clinical experience suggests that real-time CT fluoroscopy allows to perform effective and secure percutaneous abdominopelvic interventional procedures. However, because of substantial radiation exposure, its use has to be limited to specific et selected cases.