Modern CT machines with a 32 slice and above capability offer CT fluroscopic functions for use in CT guided procedures.
This has several advantages:
a. More control to operating radiologist
b. Speedier procedure
c. Lower dose procedure
Initial systems allowed for a single slice to be shown - this had its limitations. However, one can now acquire 3 images (head, centre, feet) given much more confidence on the exact needle position.
The process of biopsy remains otherwise the same, with a flawless biopsy ( no repositioning due to angulation of patient movement ) having 5 steps.
A. Image aqusition with markers to plan approach.
B. Check of maintained position and angulation planning with infiltration needle.
C. Co-axial insertion - check correct route prior to pleural breech.
D. Advancement of co-axial needle to lesion and biopsy aqusition.
E. Post biopsy pneumothorax check.