CT fluoroscopy-guided interventions in intracranial disease

Real-time CT fluoroscopy (CTF), which permits real-time monitoring of CT images at a rate of 8 images per second with a 0.5 s delay time, has recently entered clinical use. The purpose of this paper is to evaluate the usefulness of CTF as a tool for guiding intracranial interventions. Twenty-six interventional procedures were undertaken in 16 patients under CTF guidance. These included puncture of intracranial hematoma (n=8), hematoma drainage (n=9), cerebrospinal fluid (CSF) drainage (n=3), biopsy of intracranial tumors (n=4), and marking of intracerebral tumors (n=2). Needle puncture and placement were clearly monitored by CTF in all the cases. Hematoma puncture and drainage, CSF drainage, and tumor marking were performed successfully under CTF guidance. Biopsy failed in one patient with suspected brain tumor. Intra- and extra-tumor bleeding was observed in two patients who underwent tumor biopsy and was detected by CTF immediately after the occurrence. Our preliminary study indicates that real-time CTF is a potentially valuable tool for guiding neurosurgical interventions.