Abstract:
OBJECTIVE:To investigate the accuracy, procedure time, fluoroscopy time, and dose area product (DAP) of needle placement during percutaneous vertebroplasty (PVP) using cone-beam computed tomography (CBCT) guidance versus fluoroscopy. MATERIALS AND METHODS:On 4 spine phantoms with 11 vertebrae (Th7-L5), 4 interventional radiologists (2 experienced with CBCT guidance and two inexperienced) punctured all vertebrae in a bipedicular fashion. Each side was randomization to either CBCT guidance or fluoroscopy. CBCT guidance is a sophisticated needle guidance technique using CBCT, navigation software, and real-time fluoroscopy. The placement of the needle had to be to a specific target point. After the procedure, CBCT was performed to determine the accuracy, procedure time, fluoroscopy time, and DAP. Analysis of the difference between methods and experience level was performed. RESULTS:Mean accuracy using CBCT guidance (2.61 mm) was significantly better compared with fluoroscopy (5.86 mm) (p < 0.0001). Procedure time was in favor of fluoroscopy (7.39 vs. 10.13 min; p = 0.001). Fluoroscopy time during CBCT guidance was lower, but this difference is not significant (71.3 vs. 95.8 s; p = 0.056). DAP values for CBCT guidance and fluoroscopy were 514 and 174 mGy cm(2), respectively (p < 0.0001). There was a significant difference in favor of experienced CBCT guidance users regarding accuracy for both methods, procedure time of CBCT guidance, and added DAP values for fluoroscopy. CONCLUSION:CBCT guidance allows users to perform PVP more accurately at the cost of higher patient dose and longer procedure time. Because procedural complications (e.g., cement leakage) are related to the accuracy of the needle placement, improvements in accuracy are clinically relevant. Training in CBCT guidance is essential to achieve greater accuracy and decrease procedure time/dose values.
journal_name
Cardiovasc Intervent Radioljournal_title
Cardiovascular and interventional radiologyauthors
Braak SJ,Zuurmond K,Aerts HC,van Leersum M,Overtoom TT,van Heesewijk JP,van Strijen MJdoi
10.1007/s00270-013-0598-ysubject
Has Abstractpub_date
2013-08-01 00:00:00pages
1120-6issue
4eissn
0174-1551issn
1432-086Xjournal_volume
36pub_type
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journal_title:Cardiovascular and interventional radiology
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journal_title:Cardiovascular and interventional radiology
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journal_title:Cardiovascular and interventional radiology
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journal_title:Cardiovascular and interventional radiology
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journal_title:Cardiovascular and interventional radiology
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journal_title:Cardiovascular and interventional radiology
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更新日期:2010-06-01 00:00:00
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journal_title:Cardiovascular and interventional radiology
pub_type: 杂志文章,评审
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journal_title:Cardiovascular and interventional radiology
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journal_title:Cardiovascular and interventional radiology
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journal_title:Cardiovascular and interventional radiology
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journal_title:Cardiovascular and interventional radiology
pub_type: 杂志文章
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更新日期:1996-07-01 00:00:00
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journal_title:Cardiovascular and interventional radiology
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journal_title:Cardiovascular and interventional radiology
pub_type: 杂志文章
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