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Scout-guided needle placement—a technical approach for dose reduction in CT-guided periradicular infiltration

  • Spinal Neuroradiology
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Abstract

Purpose

To develop and evaluate a technical approach for CT-guided periradicular infiltration using quantitative needle access and guidance parameters extracted from CT scout images.

Methods

Five 3D-printed phantoms of the abdomen mimicking different patients were used to develop a technical approach for scout-guided periradicular infiltration. The needle access point, puncture depth, and needle angulation were calculated using measurements extracted from anterior-posterior and lateral CT scout images. Fifty needle placements were performed with the technique thus developed. Dose exposure and number of image acquisitions were compared with ten procedures performed using a conventional free-hand technique. Data were analyzed with the Mann-Whitney U test.

Results

Parameters derived solely from scout images provided adequate guidance for successful and reliable needle placement. Needle guidance was performed with the same equipment as the standard periradicular infiltration. Two scout images and 3.5 ± 2.3 (mean ± SD) single-shot images for needle positioning were acquired. Mean DLP ± SD was 3.8 ± 2.5 mGy cm. The number of single-shot acquisitions was reduced by 68% and the overall dose was reduced by 84% in comparison with the conventional free-hand technique (p < 0.0001).

Conclusion

Scout-guided needle placement for periradicular infiltration is feasible and reduces radiation exposure significantly.

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Funding

This study has received funding from the Bundesministerium für Wirtschaft und Energie (DE): 03EFHBE093.

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Authors and Affiliations

  1. Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany

    Maximilian Nunninger, Victor Paul Bela Braun, Marco Ziegert, Felix Benjamin Schwarz, Bernd Hamm & Paul Jahnke

  2. Department of Neuroradiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany

    Michael Scheel

Authors
  1. Maximilian Nunninger
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  2. Victor Paul Bela Braun
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  3. Marco Ziegert
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  4. Felix Benjamin Schwarz
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  5. Bernd Hamm
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  6. Michael Scheel
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  7. Paul Jahnke
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Corresponding author

Correspondence to Maximilian Nunninger.

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Conflict of interest

PJ and MS are shareholders of a company manufacturing CT phantoms.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Nunninger, M., Braun, V.P.B., Ziegert, M. et al. Scout-guided needle placement—a technical approach for dose reduction in CT-guided periradicular infiltration. Neuroradiology 62, 341–346 (2020). https://doi.org/10.1007/s00234-019-02339-1

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  • DOI: https://doi.org/10.1007/s00234-019-02339-1

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