title: Complications in CT-guided procedures: do we really need postinterventional CT control scans?
abstract: OBJECTIVE
  The aim of this study is twofold: to determine the complication rate in computed tomography (CT)-guided biopsies and drainages, and to evaluate the value of postinterventional CT control scans.
  
  
  METHODS
  Retrospective analysis of 1,067 CT-guided diagnostic biopsies (n = 476) and therapeutic drainages (n = 591) in thoracic (n = 37), abdominal (n = 866), and musculoskeletal (ms) (n = 164) locations. Severity of any complication was categorized as minor or major. To assess the need for postinterventional CT control scans, it was determined whether complications were detected clinically, on peri-procedural scans or on postinterventional scans only.
  
  
  RESULTS
  The complication rate was 2.5 % in all procedures (n = 27), 4.4 % in diagnostic punctures, and 1.0 % in drainages; 13.5 % in thoracic, 2.0 % in abdominal, and 3.0 % in musculoskeletal procedures. There was only 1 major complication (0.1 %). Pneumothorax (n = 14) was most frequent, followed by bleeding (n = 9), paresthesia (n = 2), material damage (n = 1), and bone fissure (n = 1). Postinterventional control acquisitions were performed in 65.7 % (701 of 1,067). Six complications were solely detectable in postinterventional control acquisitions (3 retroperitoneal bleeds, 3 pneumothoraces); all other complications were clinically detectable (n = 4) and/or visible in peri-interventional controls (n = 21).
  
  
  CONCLUSIONS
  Complications in CT-guided interventions are rare. Of these, thoracic interventions had the highest rate, while pneumothoraces and bleeding were most frequent. Most complications can be detected clinically or peri-interventionally. To reduce the radiation dose, postinterventional CT controls should not be performed routinely and should be restricted to complicated or retroperitoneal interventions only.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany, johanna.nattenmueller@med.uni-heidelberg.de.
authors.forename: Johanna
authors.initials: J
authors.lastname: Nattenmüller
authors.forename: Matthias
authors.initials: M
authors.lastname: Filsinger
authors.forename: Mark
authors.initials: M
authors.lastname: Bryant
authors.forename: Wolfram
authors.initials: W
authors.lastname: Stiller
authors.forename: Boris
authors.initials: B
authors.lastname: Radeleff
authors.forename: Lars
authors.initials: L
authors.lastname: Grenacher
authors.forename: Hans-Ullrich
authors.initials: HU
authors.lastname: Kauczor
authors.forename: Waldemar
authors.initials: W
authors.lastname: Hosch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods*; D002648:Child; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011677:Punctures; D011835:Radiation Protection; D015641:Radiography, Interventional; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed