CT-guided aspirations for the body: comparison of hand guidance with stereotaxis.

Abstract

Forty computed tomography (CT)-assisted aspirations performed with only hand guidance were prospectively compared with 40 performed with a CT body-stereotaxic system. Although there was no statistically significant difference in lesion size and path length between the two groups, use of stereotaxis compared with hand guidance decreased by 75% the number of needle manipulations required to place a needle within a lesion. With the stereotaxic method, only 43 needle manipulations were required to confirm a needle placement in 40 lesions, with no lesion requiring more than two attempts. Use of stereotaxis decreased the number of localization scans by 80% and biopsy time by 50%. It is concluded that CT-guided needle placements with hand guidance are often inaccurate and, unless the lesion is large, require multiple needle manipulations to place a needle within the lesion. Stereotaxis-guided biopsies, on the other hand, decrease radiation exposure, biopsy time, and trauma from multiple needle punctures.

Multicenter evaluation of a new laser guidance system for computed tomography intervention

“…These interventions have traditionally been performed using the freehand technique. To improve the puncture accuracy, numerous devices have been constructed varying from low cost devices to highly sophisticated systems integrated into the CT unit and connected to the CT software (2,10,11,13). The device presented in this study is not physically connected to the CT nor to the CT software and the angle of insertion must be manually entered into the operator panel.…”

Accuracy and efficacy of percutaneous biopsy and ablation using robotic assistance under computed tomography guidance: a phantom study

“…Vulnerable anatomy (such as bowel, nerves or vessels in proximity to the target) has low tolerance for needle placement errors. With conventional techniques, challenging biopsy targets frequently mandate multiple needle adjustments and intra-procedural imaging, which can prolong procedure duration, and increase patient radiation exposure and procedural risk [3, 4]. Needle-based thermal ablation such as radiofrequency ablation (RFA) induces coagulative necrosis of tumours such as hepatocellular carcinoma, hepatic metastases and renal cell carcinoma [1, 3, 5–8].…”

Technology improvements for image-guided and minimally invasive spine procedures

“…Cervical spine biopsy is more difficult, with a higher rate of complication and lower reports of success due to the complexity of surrounding anatomy [57]. We believe that robotically assisted image-guided biopsy will be able to target and sample lesions with 2 mm precision, exceeding the accuracy of the freehand technique [58]. We expect the rate of success to be higher for robotic biopsy of all spinal levels.…”