CT GUIDED BIOPSY

Last Updated on June 23, 2022 by Muhamad Aiman Aqil

Anatomy of Thorax, Abdomen and Pelvis

Image taken from Microbe Notes

Appearance of CT Guided Biopsy Images

Auto scroll of CT TAP image in axial cut.

Examination Overview

Protocol Structure

00_Biopsy_Intervention (Adult)
  • Topogram
  • Biopsy Planning
  • i-Sequence
  • Post Aspiration (if indicated)

Topogram

  • Region of Interest (ROI)will be decided by Interventional Radiologist (IR)

Topogram Parameters

  • Topogram length: 512 mm
  • Slice: 0.6 mm
  • Scanning direction: Craniocoudal
  • Tube position: Top
  • Stop the topogram scanning when the scanning cover the entire ROI.

Biopsy Planning

  • Plan the Scan FOV (SFOV) box at topogram image.
  • Start and end level is depend on IR’s request
  • Reconstruct the thin slice of the images
  • Series of thin slice images is inserted in ‘Viewing’
  • IR will choose which slice that will be the guideline along the procedure
  • Insert the slice position (SP) in ‘Table: Position’

Scanning Parameters

  • kV: 100 kV
  • mAs: Tube Current Modulation (TCM)
  • Scanning Direction: Craniocaudal
  • Scan Delay: 4 s
  • Slice: 5.0mm
  • Image Comment: Pre-Contrast
  • Pitch: 0.6
  • Quality Reference mAs : 230

Reconstruction of Biopsy Planning

Recon 1Recon 2
NameBiopsy Planning 5.0 B31fBiopsy Planning 1.0 B31f
Slice Thickness5.0 mm1.5 mm
Increment3.5 mm1.0 mm
KernelB31f medium smoothB31f medium smooth
WindowingMediastinumMediastinum

i-Sequence

 

 

  • IR will save the specific position using their control panel.
  • Select ‘HandCare’ based on puncture side and needle position
  • Change ‘start button’ to ‘foot switch’ to enable IR start the scan by their own
  • Make sure correct monitor position is selected

Reconstruction of i-Sequence

Recon 1
Namei-Sequence 4.8 B31s
Slice Thickness4.8 mm
IncrementN/A
KernelB31s medium smooth
WindowingMediastinum

Post Aspiration (Optional)

  • Post aspiration scan is depend on IR’s request
  • It may be without contrast or with contrast

Reconstruction of Post Aspiration

  • Reconstruction based on part to be examined
  • E.g : Thorax –  mediastinum window, lung window

Series of Images Send to PACS

  1. Topogram 0.6 T20f
  2. Biopsy Planning 5.0 B31f
  3. Biopsy Planning 1.5 B31f
  4. i-Sequence 4.8 B31s
  5. Post Aspiration (if available)
  6. Patient Protocol

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