title: Cone-Beam CT with Fluoroscopic Overlay Versus Conventional CT Guidance for Percutaneous Abdominopelvic Abscess Drain Placement.
abstract: OBJECTIVE
  To compare technical success and procedure time for percutaneous abscess drain placement with fluoroscopic cone-beam computed tomography (CT) and two-axis needle guidance versus conventional CT guidance.
  
  
  METHODS
  A total of 85 consecutive patients undergoing abdominopelvic abscess drain placement guided by fluoroscopic cone-beam CT or conventional CT were retrospectively reviewed over a 2-year period. Forty-three patients underwent drain placement with cone-beam CT using XperGuide navigation and 42 underwent placement with conventional 64-slice CT. Patient characteristics, median abscess size (6.8 cm vs 7.8 cm; P = .14), and depth to abscess (7.2 cm vs 7.7 cm; P = .88) were similar between groups.
  
  
  RESULTS
  Technical success rates were 98% (42 of 43) in the cone-beam CT group and 100% (42 of 42) in the conventional CT group (P = .32), with a 10-F pigtail drainage catheter inserted in the majority of cases. There were no complications in either group. There was no significant difference in effective dose between groups (9.6 mSv vs 10.7 mSv; P = .30). Procedure times were significantly shorter in the cone-beam CT group (43 min vs 62 min; P = .02). In addition, during the study period, there was a gradual improvement in procedure time in the cone-beam CT group (50% reduction), whereas procedure time did not change for the conventional CT group.
  
  
  CONCLUSIONS
  Cone-beam CT guidance appears to be equivalent to conventional CT guidance for drain placement into medium-sized abdominopelvic collections, yielding similar technical success rates and radiation doses, with the additional benefit of reduced procedure times.
authors.affiliation: University of Washington School of Medicine University of Washington, Box 357115, 1959 NE Pacific St., Seattle, WA 98119.
authors.forename: Tyler
authors.initials: T
authors.lastname: McKay
authors.affiliation: Department of Interventional Radiology, University of Washington, Box 357115, 1959 NE Pacific St., Seattle, WA 98119.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Ingraham
authors.affiliation: Department of Interventional Radiology, University of Washington, Box 357115, 1959 NE Pacific St., Seattle, WA 98119.
authors.forename: Guy E
authors.initials: GE
authors.lastname: Johnson
authors.affiliation: Department of Interventional Radiology, University of Washington, Box 357115, 1959 NE Pacific St., Seattle, WA 98119.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Kogut
authors.affiliation: Department of Interventional Radiology, University of Washington, Box 357115, 1959 NE Pacific St., Seattle, WA 98119.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Vaidya
authors.affiliation: Department of Interventional Radiology, University of Washington, Box 357115, 1959 NE Pacific St., Seattle, WA 98119. Electronic address: spadia@uw.edu.
authors.forename: Siddharth A
authors.initials: SA
authors.lastname: Padia
mesh_terms: D018784:Abdominal Abscess / Q000000981:diagnostic imaging* / Q000628:therapy*; D000038:Abscess / Q000000981:diagnostic imaging / Q000628:therapy; D000328:Adult; D000368:Aged; D054893:Cone-Beam Computed Tomography / Q000379:methods; D004322:Drainage / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000000981:diagnostic imaging; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult