Navigation Systems Significantly Improve the Efficiency and Safety of CT-Guided Interventions

TL;DR

Navigation systems improve the safety and efficiency of CT-guided medical procedures like biopsies and tumor ablations.

Contribution

A systematic review and meta-analysis of 30 studies shows navigation systems reduce complications, radiation exposure, and procedure time in CT-guided interventions.

Findings

Navigation systems reduced needle adjustments and shortened procedure time by about 8 minutes.

Radiation exposure decreased by 37% with navigation systems.

Diagnostic success improved, and complications like chest tube insertions were reduced in lung ablations.

Abstract

Computed tomography-guided interventions, such as biopsies and tumor ablations, are widely used to diagnose and treat cancer, but they often require multiple needle adjustments, expose patients to radiation, and may cause complications. Navigation systems have been developed to help physicians place needles more accurately during these procedures, but their overall benefit has not been fully clarified. In this study, we systematically reviewed and combined data from 30 clinical studies involving nearly 2800 patients to compare navigation-assisted procedures with conventional techniques. We found that navigation systems reduced the number of needle adjustments, shortened procedure time, lowered radiation exposure, and decreased complication rates, while improving diagnostic success. These results suggest that navigation systems can make computed tomography-guided interventions safer and more efficient, supporting their wider adoption in clinical practice and future research.

Objectives: CT-guided interventions are associated with radiation exposure, prolonged procedural time, and complications. Navigation systems (NS) have been developed to improve procedural precision and efficiency. This study aimed to evaluate the impact of NS on procedural outcomes, radiation dose, and complication rates compared with conventional freehand techniques. Materials and methods: A systematic review and meta-analysis was performed including 30 studies (11 randomized controlled trials, 19 cohort studies) published through November 2023, involving 2785 patients (1418 NS; 1367 control). Outcomes included the number of needle manipulations, procedural time, radiation dose, complication rates, technical success, and diagnostic success. Random-effects models were applied with subgroup analyses by study design, intervention type, and target organ. Risk of bias was assessed using RoB 2 and ROBINS-I, and certainty of evidence using the GRADE framework. Results: Navigation systems significantly reduced needle manipulations (mean difference [MD], −2.58; 95% CI: −3.30 to −1.85) and procedural time (MD, −8.07 min; 95% CI: −12.27 to −3.87). Radiation dose decreased by 37% (ratio of means [ROM], 0.63; 95% CI: 0.58–0.69). Complication rates were lower overall (odds ratio [OR], 0.64), with fewer chest tube insertions during lung ablations (OR, 0.58; 95% CI: 0.39–0.86). Diagnostic success improved (OR, 1.66; 95% CI: 1.01–2.73), whereas technical success was comparable (OR, 1.41; 95% CI: 0.89–2.24). Conclusions: Navigation systems significantly enhance the efficiency and safety of CT-guided interventions by reducing needle manipulations, radiation exposure, and complication rates, while improving diagnostic success.

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