CT Navigation for Percutaneous Needle Placement: How I Do It

Anna M. Sorensen, Annie M. Zlevor, Meridith A. Kisting, Allison B. Couillard, Timothy J. Ziemlewicz, Giuseppe V. Toia, J. Louis Hinshaw, Michael Woods, Lindsay M. Stratchko, Perry J. Pickhardt, Marcia L. Foltz, Walter W. Peppler, Fred T. Lee, Erica M. Knavel Koepsel

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


CT navigation (CTN) has recently been developed to combine many of the advantages of conventional CT and CT-fluoroscopic guidance for needle placement. CTN systems display real-time needle position superimposed on a CT dataset. This is accomplished by placing electromagnetic (EM) or optical transmitters/sensors on the patient and needle, combined with fiducials placed within the scan field to superimpose a known needle location onto a CT dataset. Advantages of CTN include real-time needle tracking using a contemporaneous CT dataset with the patient in the treatment position, reduced radiation to the physician, facilitation of procedures outside the gantry plane, fewer helical scans during needle placement, and needle guidance based on diagnostic-quality CT datasets. Limitations include the display of a virtual (vs actual) needle position, which can be inaccurate if the needle bends, the fiducial moves, or patient movement occurs between scans, and limitations in anatomical regions with a high degree of motion such as the lung bases. This review summarizes recently introduced CTN technologies in comparison to historical methods of CT needle guidance. A “How I do it” section follows, which describes how CT navigation has been integrated into the study center for both routine and challenging procedures, and includes step-by-step explanations, technical tips, and pitfalls.

Original languageEnglish (US)
Article number100911
JournalTechniques in Vascular and Interventional Radiology
Issue number3
StatePublished - Sep 2023

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this