Abstract
Objective
To determine the frequency and causes of canceled or aborted CT-guided interventions (biopsies, cytological aspirations, hookwire localizations, and catheter drainages), associations with patient and procedural variables, and subsequent management.
Methods
This study included 3052 consecutive CT-guided interventions (2487 biopsies, 80 cytological aspirations, 223 hookwire localizations, and 262 catheter drainages) performed in a single institution within a 13-year period.
Results
Fifty-two of 3052 CT-guided interventions were canceled or aborted, corresponding to a frequency of 1.7% (95% confidence interval [CI] 1.3–2.2%). Main causes in order of decreasing frequency included pain, lack of a safe window for intervention, impossibility to position the co-axial or biopsy needle in or near the target, inability to lie still, dyspnea and low oxygen saturation levels, non-discontinuation of anticoagulant therapy, impossibility to aspirate fluid or pus when attempting drainage, and impossibility to advance the drainage catheter in a fluid collection or abscess. On multivariate analysis, only catheter drainages and head-neck interventions were significantly at risk (p = 0.019 and p = 0.004) to be canceled or aborted, with odds ratios of 2.677 (95% CI 1.178–6.083) and 6.956 (95% CI 1.883–25.691), respectively. Of 52 canceled or aborted CT-guided interventions, 14 (26.9%) were repeated, 19 (36.5%) underwent a different non-CT-guided interventional procedure on the same target, and 19 (36.5%) did not undergo any subsequent intervention.
Conclusion
The frequency of canceled or aborted CT-guided interventions is low, but is not negligible. Awareness of causes and circumstances under which they are more likely to occur may reduce the number of canceled or aborted CT-guided interventions.
Key Points
• Approximately 1.7% of CT-guided interventions, for which the patient physically shows up at the CT room and which are considered useful by the radiologist, are eventually canceled or aborted.
• Main causes (of which some may be prevented) are pain, lack of a safe window, impossibility to position the co-axial or biopsy needle, inability to lie still, dyspnea, non-discontinuation of anticoagulant therapy, and impossibility to aspirate liquid or advance the catheter when attempting drainage.
• CT-guided catheter drainages and head-neck interventions are particularly prone to being canceled or aborted.
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Abbreviations
- CI:
-
Confidence interval
- CT:
-
Computed tomography
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The authors state that this work has not received any funding.
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The scientific guarantor of this publication is Thomas C. Kwee.
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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
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No complex statistical methods were necessary for this paper.
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Written informed consent was waived by the local Institutional Review Board.
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Local Institutional Review Board approval was obtained.
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• retrospective
• diagnostic study
• performed at one institution
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Yakar, D., Kwee, T.C. Canceled or aborted CT-guided interventions: 13-year clinical experience at a tertiary care center. Eur Radiol 29, 3372–3378 (2019). https://doi.org/10.1007/s00330-018-5991-0
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DOI: https://doi.org/10.1007/s00330-018-5991-0