What Is This Procedure?

CT-guided interventions are minimally invasive procedures performed using CT imaging to precisely guide a needle to a specific location within the body.

CT provides detailed anatomical imaging and allows the radiologist to confirm the position of the needle in relation to bones, joints, nerves, organs and other important structures.

This makes CT guidance particularly useful for targets that are deep within the body, anatomically complex or difficult to visualise using other imaging techniques.

At IMPACT Radiology, CT guidance is used for a broad range of pain management, therapeutic and diagnostic procedures.

Procedures We Commonly Perform

Spine & Pain Management

CT guidance allows highly accurate placement of medication around specific spinal joints and nerves.

• Procedures include:
• Nerve root injections
• Facet joint injections
• Epidural injections
• Sacroiliac joint injections
• Selected spinal pain procedures

These procedures may be used to investigate or treat conditions such as:

• Sciatica
• Radiculopathy
• Nerve root pain
• Facet joint pain
• Spinal degenerative disease
• Sacroiliac joint pain
• Chronic neck or back pain

Joint Injections

CT guidance can be particularly useful for accurately accessing deep joints or joints that are difficult to approach clinically.

• Procedures may include injections involving the:
• Hip
• Shoulder
• Knee
• Sacroiliac joint
• Other selected joints
• Depending on your condition, injections may include:
• Corticosteroid and local anaesthetic
• Platelet-Rich Plasma (PRP)
• Hyaluronic acid injections
• Other medications or therapeutic agents where clinically appropriate

Platelet-Rich Plasma (PRP) Injections

PRP uses a concentrated preparation of platelets obtained from your own blood.

CT guidance can be used when the target is deep or requires particularly precise needle placement.PRP may be considered for selected musculoskeletal conditions following clinical and imaging assessment.

Biopsies

CT guidance can be used to obtain tissue samples from abnormalities located deep within the body.

Depending on the clinical circumstances, CT-guided biopsy may be performed for abnormalities involving:

• Lymph nodes
• Soft tissues
• Other selected masses or lesions

The tissue sample is sent to a pathology laboratory for analysis.

Aspiration & Drainage

CT guidance can be used to accurately access and drain abnormal fluid collections.

• These may include:
• Abscesses
• Seromas
• Post-operative collections
• Haematomas
• Other abnormal fluid collections

Samples can also be sent to pathology or microbiology when required.

Marker Placement

CT guidance can be used to accurately place a marker within a lesion.

• This may assist with:
• Surgical planning
• Identification of a lesion
• Treatment planning
• Other specialised procedures

Pre-Surgical Botulinum Toxin (Botox) Injection

In selected patients undergoing abdominal wall or complex hernia surgery, image-guided botulinum toxin injections may be requested by the treating surgeon.

The injections are carefully placed into selected abdominal wall muscles to temporarily relax these muscles before surgery.This can assist with the management of selected large or complex abdominal wall hernias.

Ethanol (ETOH) Ablation

CT-guided ethanol (alcohol) ablation is a minimally invasive treatment in which ethanol is precisely injected into a targeted lesion under imaging guidance.

• It may be used for selected:
• Neuromas
• Nerve root with perineural tumoural spread
• Medial branchablation
• Recurrent cysts

CT guidance allows accurate needle placement while helping avoid nearby important structures.Suitability for ethanol ablation is assessed individually by the radiologist in consultation with your referring doctor or specialist.

Other Customised CT-Guided Procedures

• Some conditions require an individualised approach.

Our radiologists can review the clinical question and relevant imaging to determine whether a customised CT-guided intervention may be appropriate.

Why Might My Doctor Request This Procedure?

• Neck or back pain
• Sciatica or radiculopathy
• Facet joint pain
• Sacroiliac joint pain
• Joint pain or arthritis
• Targeted pain management
• PRP treatment
• Joint injection
• Obtaining a biopsy from a mass or abnormality
• Aspiration of an abnormal fluid collection
• Drainage of an abscess or collection
• Marker placement
• Pre-operative treatment
• A procedure requiring precise access to a deep or difficult anatomical location

Preparation

Medications & Blood Thinners

Please tell us if you take any blood-thinning or antiplatelet medications.

These medications may need to be reviewed before certain procedures.

Do not stop any prescribed blood-thinning medication unless you have been specifically instructed to do so by your doctor or our radiology team.

Fasting

Some procedures may require you to fast for several hours beforehand.

You will be provided with specific instructions when your appointment is arranged.

Blood Tests

For some biopsies and other procedures, recent blood tests may be required to assess your blood clotting and other relevant factors.

Previous Imaging

Where possible, relevant previous imaging will be reviewed before the procedure to determine the safest and most appropriate approach.Please let us know if important previous imaging was performed at another imaging provider or hospital.

What Happens During the Procedure?

Before the procedure, the radiologist will review your imaging and determine the safest route to the target.

You will be positioned on the CT table according to the area being treated.

An initial CT scan is performed to identify the exact target and surrounding structures.

The skin is cleaned, and local anaesthetic is administered to numb the area.

Using CT guidance, the radiologist carefully advances a needle towards the target. Additional CT images are obtained during the procedure to confirm and adjust the needle position.

Once accurate positioning has been confirmed, the planned injection, biopsy, aspiration or other treatment is performed.

A small dressing is usually placed over the needle site afterwards.