| Current Challenges |
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| Currently difficult procedures like biopsy, FNAC, RFA, implanting fiducial markers, dye insertion, etc. are performed under the guidance of an imaging modality like Ultrasound or CT scanners; as a result the technicians face the following problems: |
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| Unguided |
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| The nature of organs like Lungs, Bones and a few structures in Abdomen prohibit the use of Ultrasound for guided procedures. In such scenarios CT scanners are the only options to guide positioning of the needle, which results in a trial and error situation. |
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| More Radiation |
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| To determine the accurate positioning of the needle CT Fluoroscopy is used. |
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Over exposure to ionizing radiation emitted from Fluoroscope, to the patient & the technician, result in elevating a person’s lifetime risk of developing cancer. |
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Ionizing radiation has enough energy to potentially cause damage to DNA. X-rays are a type of ionizing radiation. FDA has already issued warnings in using Fluoroscopy for guided procedures due to the risks with increased exposure |
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On the clinical front - continuous CT fluoroscopy procedures load the CT tubes heavily and impact the life CT tube and equipment; thereby increasing the costs of maintenance and faster run down of the equipment. |
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| More Patient Punctures |
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| Currently Most of the CT guided procedures are done using free hand technique and have the following constraints: |
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Since the procedure is done using free hand the margin for human error is considerably high |
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Complicated cases where there are remote lesions, lesions located in a small cavity, limited approach or angulated approach and / or lesions adjoining blood vessels or other Critical organs – require multiple insertions to determine and reach the exact location of the lesion resulting in patient discomfort. |
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| Time Consuming |
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| Currently Most of the CT guided procedures are done using free hand technique as a result: |
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Multiple CT scans are required to determine the exact location of the lesion |
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A trial and error approach is employed where in repeated and multiple insertions are done to determine the location and reach the lesion – causing patient discomfort and a time consuming process |
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| Small Lesions - An impossible procedure |
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| By experience and skill acquired over a long period clinicians / radiologists are comfortable with large lesions. If the Lesion size is smaller, for e.g., 3mm or less, it becomes extremely risky to try freehand technique and only a very few clinicians would attempt to do that. |
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