Indications, Technique and Pitfalls

Abstract

In addition to serving as a diagnostic imaging modality, the use of Computed Tomography (CT) to guide interventional procedures has increased dramatically in the past decade. This is linked to more sophisticated technology available on CT scanners, including interventional options, allowing for ‘live’ 3-dimensional data to guide the interventionalist to perform the procedure more safely. Interventional CT includes a wide range of procedures such as musculoskeletal joint injections, nerve root corticosteroid injections, aspirations, biopsies, drainages, radiofrequency ablations and transarterial chemoembolisations. The ALARA principle requires consideration of the benefits and risks associated with the use of ionising radiation when performing such interventional procedures. When deciding on the most appropriate modality to guide an intervention, radiation dose and potential complications are two major concerns to be considered. CT fluoroscopy may deliver higher radiation dose than conventional fluoroscopy, but the value of the 3-dimensional data provided by CT to minimise the associated risks or complications to the patient will usually outweigh the radiation-related risks. Radiographers are an integral part of the multidisciplinary team (MDT) when interventional CT procedures are being performed. Therefore, it is vital to the success of the MDT that radiographers understand the aim of the procedure and the associated risks so that they can provide optimal imaging in a timely manner whilst minimising the radiation dose to both the patient and the members of the MDT who may have to remain in the CT scan room during exposure.