Real time CT-fluoroscopy: diagnostic and therapeutic applications

The synergetic progression of CT technology and computer hardware has made ultrafast acquisition and image reconstruction possible. This has lead to t he availability of CT interactive diagnosis and therapeutic procedures. Mal ting use of our own material (337 intervention procedures during the last 1 7 months), we have compared our techniques and results to the recent litera ture data. One of the advantages of the biopsy technique is an improved sen sitivity for neoplastic lesions, most certainly in cases of intrapulmonary lesions, surrounded by aerated tissue (now 94% compared to 87% in our previ ous study). A second advantage is the safety of the technique (only one maj or complication in our series). Fluid collection drainages, and more comple x interventions like local injection of drugs, radio-frequency ablation, wi re hook placement and ethanol injection were performed without complication . Yet another interesting feature is the shortening of the procedure time ( reduced in average to an 'in-room' time of less than 30 min), which has def inite economical implications. Furthermore it increases the patient's comfo rt and safety, and extends the scope of outpatient procedures (80% outpatie nt procedures in our material). On the other side the radiation exposure ca n be raised as an issue, especially when we consider the operator's hands. However, the described technique and the use of dedicated tools call allevi ate the problem. As a conclusion, real time CT fluoroscopy has given a new input and broadens the scope of clinical indications of CT-guided diagnosti c and therapeutic procedures. (C) 2000 Elsevier Science Ireland Ltd. All ri ghts reserved.