CT fluoroscopy-assisted puncture of thoracic and abdominal masses: A randomized trial

PURPOSE: We investigated the benefit of real-time guidance of interventional punctures by means of computed tomography fluoroscopy (CTF) compared with the conventional sequential acquisition guidance. MATERIAL AND METHODS: In a prospective randomized trial, 75 patients underwent either CTF-guided (group A, n = 50) or sequential CT-guided (group B, n = 25) punctures of thoracic (n = 29) or abdominal (n = 46) masses. CTF was performed on the CT machine (Somatom Plus 4 Power, Siemens Corp., Forchheim, Germany) equipped with the C.A.R.E. Vision application (tube voltage 120 kV, tube current 50 mA, rotational time 0.75 s, slice thickness 10 mm, 8 frames/s). RESULTS: The average procedure time showed a statistically significant difference between the two study groups (group A: 564 s, group B 795 s, P = 0.0032). The mean total mAs was 7089 mAs for the CTF and 4856 mAs for the sequential image-guided intervention, respectively. The sensitivity was 71% specificity 100% positive predictive value 100% and negative predictive value 60% for the CTF-guided puncture, and 68, 100, 100 and 50% for sequential CT, respectively. CONCLUSION: CTF guidance realizes a time-saving but increases the radiation exposure dosage. (C) 2002 The Royal College of Radiologists.