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Comparison of Sonographic and CT Guidance Techniques

Does CT Fluoroscopy Decrease Procedure Time?

Douglas H. Sheafor1, Erik K. Paulson, Mark A. Kliewer, David M. DeLong and Rendon C. Nelson

1 All authors: Department of Radiology, Duke University Medical Center, Box 3808, Erwin Rd., Durham, NC 27710.



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  		Fig. 1. —Drawing of abdominal phantom used for CT and sonographically guided biopsies shows target lesions (7, 10, and 20 mm in diameter) suspended 3 and 7 cm below the surface. R = simulated ribs.

 


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  		Fig. 2A. —Images of 20-gauge needle biopsies of simulated lesions, using helical and fluoroscopic CT and sonography with needle guide. Helical CT image (140 kVp, 110 mA, 10-mm collimation) shows three target lesions (arrowheads) at depth of 7 cm. Tip of biopsy needle is in middle target (arrow).

 


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  		Fig. 2B. —Images of 20-gauge needle biopsies of simulated lesions, using helical and fluoroscopic CT and sonography with needle guide. CT fluoroscopic image (140 kVp, 10 mA, 10-mm collimation) of same lesion shows excellent needle tip localization (arrow). Note slight reduction in image quality for this technique.

 


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  		Fig. 2C. —Images of 20-gauge needle biopsies of simulated lesions, using helical and fluoroscopic CT and sonography with needle guide. Sonogram shows biopsy needle tip (arrow) in 10-mm lesion at depth of 7 cm. Dotted lines represent projected needle course with attachable needle guide.

 


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  		Fig. 3. —Photograph of Ultraguide (Ultraguide 1000; Ultraguide, Lakewood, CO) monitor during 20-gauge needle biopsy of simulated lesion using freehand sonography with computer guidance. Black arrow indicates biopsy needle tip in 10-mm target at depth of 7 cm. Computer-generated solid lines localize needle and needle tip during freehand approach. Note mirror-image sonography artifact resulting in second lesion posterior to target lesion (open arrow).

 

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