CT-Guided Biopsy and Drainage

CT-guided percutaneous biopsies are performed in patients with a known primary tumor, to rule out metastatic malignancy, to establish the final diagnosis, or to differentiate between tumor necrosis and potential vital tumor tissue in residual lesions after therapy. CT-guided aspiration, punch, and drill biopsy may be performed in essentially every organ system and location, and overall complication rates are low. Given an experienced operator, using repeated single-shot CT-fluoroscopic (CTF) acquisitions for needle positioning, in comparison to sequential CT guidance, CTF can markedly reduce both the in-room time and radiation dose for the patient. Improved availability and imaging quality of CT, modified techniques of percutaneous drainage, and more effective antibiotic regimens have made CT-guided drainage a common means for percutaneous therapy of abscesses and abnormal fluid collections, representing a dramatic improvement of patient care during the last 20 years. Primary and postoperative fluid collections in nearly every organ system and multiple locations can now be safely treated percutaneously. In a collective of severely ill patients, the instant postoperative detection and consecutive therapy of abscesses under CT guidance have resulted in reduced morbidity and mortality and have helped to reduce length of hospital stay and hospital costs.