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CT Fluoroscopy-guided Abdominal Interventions: Techniques, Results, and Radiation Exposure¹

¹ From the Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 (S.G.S., K.T., D.F.A., R.D.N., K.H.Z., P.F.J.) and the Department of Health Care Policy, Harvard Medical School, Boston, Mass (K.H.Z.). From the 1998 RSNA scientific assembly. Received November 9, 1998; revision requested January 4, 1999; revision received February 12; accepted March 25. Address reprint requests to S.G.S. (e-mail: silver@ulna.bwh.harvard.edu).

PURPOSE: To evaluate the benefits of computed tomographic (CT) fluoroscopy–guided interventions and assess radiation exposures incurred with CT fluoroscopy.

MATERIALS AND METHODS: A 6-month period of use of CT fluoroscopy to guide abdominal biopsy procedures and catheter drainage was analyzed. Efficacy measures and needle placement and procedure room times were compared with those of the preceding 6 months during which conventional CT was used. CT fluoroscopic times and estimated radiation exposures were compared for two CT fluoroscopic methods.

RESULTS: The sensitivity and negative predictive values for biopsy procedures and the success rate for needle aspiration or catheter drainages for CT fluoroscopy—98%, 86%, and 100%, respectively—were not significantly different from those for conventional CT—95%, 80%, and 97%, respectively. Room time was not reduced significantly, but mean needle placement time for CT fluoroscopy (29 minutes; n = 95) was significantly lower than that for conventional CT (36 minutes; n = 93; P < .005). The mean patient dose index was 74 cGy. Limiting CT fluoroscopy to scanning the needle tip rather than scanning the entire needle pass significantly reduced the dose to the patient and the operator.

CONCLUSION: Although CT fluoroscopy is a useful targeting technique, significant radiation exposures may result. Therefore, radiologists need to be aware of different methods of CT fluoroscopic guidance and the factors that contribute to radiation exposure.

Index terms: Abdomen, interventional procedures, 70.126 • Abscess, drainage, 70.1263 • Biopsies, technology, 70.12119, 70.125 • Computed tomography (CT), guidance, 70.12119, 70.125 • Fluoroscopy, technology, 70.1261 • Radiations, exposure to patients and personnel, 70.12119

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