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Kim, Park, Lee, Chung, Park, Kook, and Rho: Initial Experience with Percutaneous Needle Aspiration of Paraspinal Lesions Using XperGuide Cone-Beam CT
Musculoskeletal Radiology
Journal of the Korean Society of Radiology

Journal of the Korean Society of Radiology 2013; 68(3): 245-250.

Published online: 18 March 2013

DOI: https://doi.org/10.3348/jksr.2013.68.3.245

Initial Experience with Percutaneous Needle Aspiration of Paraspinal Lesions Using XperGuide Cone-Beam CT

Solip Kim, MD, Hee-Jin Park, MD, So-Yeon Lee, MD, Eun-Chul Chung, MD, Hae-Won Park, MD, Shin-Ho Kook, MD, Myung-Ho Rho, MD

Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Corresponding author: Hee-Jin Park, MD. Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 110-746, Korea. Tel. 82-2-2001-1035, Fax. 82-2-2001-1030, parkhiji@gmail.com

Received 16 October 2012       Accepted 10 December 2012

Copyright © 2013 The Korean Society of Radiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aim of this study is to report our initial experience using XperGuide cone-beam computed tomography (CBCT) for percutaneous needle aspiration of the paraspinal lesions.

Materials and Methods

Between September 2011 and September 2012, 12 patients who underwent percutaneous needle aspiration of the paraspinal lesions for suspected pyogenic spondylitis, tuberculous spondylitis, or metastasis were included. The procedure was performed on the XperGuide CBCT. Based on the initial CBCT, target points and entrance were determined, using dedicated guidance software (XperGuide), and the needle pathway was visualized in various reconstructed images. Needle aspiration was performed using Westcott needle and correct needle positioning was confirmed with the second CBCT. The technical success was defined as the needle tip reached within 5 mm of the target point. Culture, smear, and polymerase chain reaction of obtained samples were performed.

Results

In all twelve patients, target areas could be determined based on XperCT data and achieved 100% technical success. Diagnosis could be made in 91.7% of cases and the median interventional procedure time was 27.8 minutes. There was no major complication in all patients.

Conclusion

Percutaneous needle aspiration of paraspinal lesions using XperGuide CBCT is easy, accurate, safe, and useful in determining the treatment of direction.

Keywords: XperGuide, Cone-Beam CT, Paraspinal Lesion, Needle Aspiration

Figures and Tables

Fig. 1
Image-guided needle procedure.
A. The Westcott needle has a beveled tip and a notched outer cannula. The side notch creates a second cutting edge and allows for aspiration of more material.
B. The procedure was done with patient setting at prone position.
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Fig. 2
A 69-year-old male, pyogenic spondylodiscitis.
A. XperCT with axial needle progression view displays the planned needle trajectory in straight line.
B. In the entry point view, entry and target points are displayed on overlaying images.
C. Hybrid image overlaying the fluoroscopic image and the XperCT in the needle progression projection shows the biopsy needle advances along the planned trajectory, displayed as a straight line.
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Table 1
Patient Characteristics
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Note.-TB = tuberculous

Table 2
Procedure-Related Information
jksr-68-245-i002

Note.-DAP = dose area product, SD = standard deviation

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