Body interventional procedures: which is the best method for CT guidance?

To compare sequential fluoroscopy guidance with spiral guidance in terms of safety, effectiveness, speed and radiation in interventional whole body procedures.

This study was a retrospective analysis of data from the prospective, randomised controlled, multicentre CTNAV2 study. The present analysis included 385 patients: 247 in the sequential group (SEQ) and 138 in the spiral group (SPI). Safety was assessed by the number of major complications. Effectiveness was measured according to the number of targets reached. Data on procedural time and radiation delivered to patients were also collected.

There was no significant difference between the two groups (SEQ vs SPI) regarding the success rate (99.6% vs 99.3%, p = 0.680), procedural time (7 min 40 s ± 5 min 48 s vs 7 min 13 s ± 7 min 33 s, p = 0.507), or major complications (2.43% vs 5.8%, p = 0.101). Radiation dose to patients was 84% lower in the sequential group (54.8 ± 51.8 mGy cm vs 352.6 ± 404 mGy cm, p < 0.0001).

Sequential CT fluoroscopy-guided whole-body interventional procedures seems to be as safe, effective and fast as spiral guidance, while also yielding a significant decrease in the radiation dose to patients.

• Sequential CT fluoroscopy and spiral acquisition are comparable in terms of safety, effectiveness and speed. • Procedural times are comparable despite an increased number of acquisitions in sequential fluoroscopy. • Radiation dose to patients is 84% lower in sequential fluoroscopy compared with spiral CT.