September 2025, Volume 3, Issue 9

Author

Paul Joseph C and Keshava Shyamkumar N

Abstract

Background and Aims: A guidance system, when integrated into CT-guided procedures, may improve the safety and outcome of the procedure. This study aimed to evaluate the error rate concerning the site of needle entry after planning with the help of an additional scan with the local anaesthetic needle in situ. Settings and Design: Consecutive cases booked for CT-guided biopsies were included in the study prospectively from 01 November 2018 to 21 November 2018. An additional CT scan was performed in the region of local anaesthetic infiltration, with needle left in situ. The location of skin entry was compared between the planning CT and the CT after placement of the local anaesthetic needle. This can be easily learned and reproduced in a different centre on different CT machinery. Any mismatch identified was corrected by inserting a local anaesthesia needle into the newly marked site and CT-guided procedure was completed. Results: There were 3/71 CT-guided biopsies in which a change in the site of skin entry was detected, out of which one was on the wrong side of the body and two were errors in Z-axis. There were 3 cases of pneumothorax noted post biopsy. There was adequate histopathological yield and radiation dose was within safe limits. Conclusions: This novel technique of checking the local needle placement prior to proceeding with the CT-guided procedure with larger needle helps to identify errors in the placement of the needle. This would further help in selecting the correct site of biopsy, improving the yield, and reducing complications.