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Laser Guidance Improves Accuracy and First-pass Success in CT-Guided Interventions: A Multicenter Randomized Trial.

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Summary
This summary is machine-generated.

Gantry-mounted laser guidance significantly improves computed tomography (CT)-guided needle puncture accuracy and success rates for thoracoabdominal lesions compared to the freehand method. This low-cost technology offers an efficient alternative without increasing procedure time or risks.

Keywords:
CT-guided punctureFirst-pass successLaser guidanceRandomized trialTargeting accuracy

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Area of Science:

  • Medical Imaging and Interventional Radiology
  • Surgical Navigation Technologies

Background:

  • Freehand computed tomography (CT)-guided percutaneous needle puncture accuracy is limited, particularly for small or challenging thoracoabdominal lesions.
  • Gantry-mounted laser navigation offers a cost-effective alternative to electromagnetic or robotic systems by projecting planned trajectories onto patients.

Purpose of the Study:

  • To evaluate if laser guidance enhances the accuracy and efficiency of CT-guided punctures compared to the conventional freehand technique.

Main Methods:

  • A multicenter randomized trial involving 170 adults with thoracic or abdominal lesions (≥10mm) was conducted.
  • Participants were assigned to either laser-guided intervention (n=85) or freehand control (n=85).
  • Primary endpoint: successful lesion access with ≤2 needle repositionings; secondary endpoints: needle-tip error, CT scan count, puncture time, and complications.

Main Results:

  • Laser guidance significantly increased successful puncture rates (91.4% vs 37.3%, P<.001) and reduced mean targeting error (2.1±0.9 mm vs 3.5±0.8 mm, P<.001).
  • Fewer confirmatory CT scans were needed with laser guidance (4.1±2.1 vs 4.9±2.4, P=.014).
  • Puncture duration and major complication rates were similar between groups.

Conclusions:

  • Gantry-mounted laser guidance substantially improves first-pass success and accuracy for CT-guided thoracoabdominal punctures.
  • It provides an efficient, low-cost alternative to freehand techniques without increasing procedure time or risk.