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Updated: May 20, 2025

Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
Published on: August 6, 2019
Cone beam computed tomography (CT)-assisted radiologically inserted gastrostomy. Technical considerations and impact
J Finnegan1, J O'Mahony1, C Reid1
1Department of Interventional Radiology, Beaumont Hospital, Beaumont Road, Dublin, Ireland.
Aim:
Intraprocedural cone beam computed tomography (CT) can provide anatomic evaluation during retrograde radiologically inserted gastrostomy (RIG). This study explores the technical and radiation dose implications of cone beam CT-assisted RIG, compared with conventional RIG technique using fluoroscopy alone.
Materials And Methods:
One hundred seven retrograde RIG procedures were included in the analysis, 48 of which were performed with cone beam CT assistance and 59 using conventional fluoroscopy alone.
Results:
Forty six of the 48 (95.8%) cone beam CT-assisted RIG procedures and 47 of the 59 (79.6%) procedures using conventional RIG technique were successful. One complication (tube malplacement) was encountered with the conventional RIG technique. Cone beam CT-assisted RIG was associated with significantly higher average dose area product (DAP) of 8.5 Gy.cm2 compared with conventional technique's DAP of 3.4 Gy.cm2. The average procedure and fluoroscopic screening time for cone beam CT-assisted RIG was significantly lower.
Conclusion:
Cone beam CT-assisted RIG is a safe and effective technique. Whilst there is an increase in radiation dose for the patient, it is counter balanced by definitive anatomical evaluation, higher success rates and lack of major complication with reduced fluoroscopic screening exposure for interventional staff.
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