RSNA 2006 

Abstract Archives of the RSNA, 2006


LL-MK4268-B03

Development of a New Support Method for the Transpedicular Punctures of Vertebral Body: Isocenter Puncture Method

Scientific Posters

Presented on November 26, 2006
Presented as part of LLMK-B: Musculoskeletal

Participants

Misako Yoshimatsu, Presenter: Nothing to Disclose
Kenji Takizawa MD,PhD, Abstract Co-Author: Nothing to Disclose
Yasuo Nakajima MD, Abstract Co-Author: Nothing to Disclose
Shinjirou Sakaino, Abstract Co-Author: Nothing to Disclose
Kunihiro Yagihashi MD, Abstract Co-Author: Nothing to Disclose
Yasuyuki Kobayashi MD, Abstract Co-Author: Nothing to Disclose

PURPOSE

Recently, in regards to percutaneous vertebroplasty(PVP) and vertebral bone biopsy, the percutaneous transpedicular puncture under fluoroscopical guidance using a C-arm radiographic system has been gaining popularity. However, the conventional puncture methods performed under fluoroscopical guidance, pinpointing the target in the vertebral body is fairly difficult. To overcome this disadvantage, the authors have developed a new support method for the transpedicular puncture; the Isocenter puncture method (ISOP).

METHOD AND MATERIALS

The Isocenter always remains at the center of the radiation field as well as the center of the monitor screen, no matter how the C-arm is rotated. The ISOP method applies this principle and adjusting the puncture target to the position of Isocenter becomes essential . For this purpose, the authors developed an Isocenter marker (ICM), which can be displayed arbitrary as a square dot on the center of the monitor screen. After positioning the puncture target to the ICM, the C-arm is rotated. The puncture direction becomes the angle of the C-arm when the ICM overlaps the center of the pediculus arcus vertebrae image. Then, puncture is conducted targeting the ICM. 32 percutaneous transpedicular punctures using the ISOP have been performed in 19 cases. As for PVP, it was 18 cases, 31 vertebral bodies, and these were all tried with the unilateral transpedicular approach. The vertebral biopsy involved 4 cases and one single biopsy with one vertebral body, while the other 3 cases were performed with PVP. The efficacy of the ISOP was determined by 3 people with PVP experience, observing whether the tip of the puncture needle reached within 5 mm radius of ICM.

RESULTS

The tip of the puncture needle successfully overlapped with the ICM in all the cases.

CONCLUSION

The ISOP, which enables pinpoint targeting under fluoroscopical guidance in the transpedicular punctures of vertebral body, shows promise in areas such as reduction of radiation exposure and reduction in operation time and cost in PVP and vertebral biopsies.

CLINICAL RELEVANCE/APPLICATION

The ISOP is useful new method for pinpoint targeting of the lesion in the vertebral body in PVP by unilateral transpedicular approach and vertebral bone biopsy .

Cite This Abstract

Yoshimatsu, M, Takizawa, K, Nakajima, Y, Sakaino, S, Yagihashi, K, Kobayashi, Y, Development of a New Support Method for the Transpedicular Punctures of Vertebral Body: Isocenter Puncture Method.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4441682.html