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Tytuł:
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Phantom study for comparison between computed tomography- and C-Arm computed tomography-guided puncture applied by residents in radiology.
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Autorzy:
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Meine TC; Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
Hinrichs JB; Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
Werncke T; Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
Afat S; Institute for Diagnostic and Interventional Radiology, University Hospital Tübingen, Germany.
Biggemann L; Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany.
Bucher A; Institute of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Germany.
Büttner M; Clinic for Diagnostic and Interventional Radiology, Ulm University Medical Center, Ulm, Germany.
Christner S; Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany.
Dethlefsen E; Clinic for Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Germany.
Engel H; Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
Gerwing M; Clinic for Radiology, University Hospital Münster, Germany.
Getzin T; Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
Gräger S; Institute for Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Germany.
Gresser E; Department of Radiology, Ludwig Maximilians University Munich, München, Germany.
Grunz JP; Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany.
Harder F; Department of Diagnostic and Interventional Radiology, Technical University of Munich, München, Germany.
Heidenreich J; Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Germany.
Hitpaß L; Clinic for Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Germany.
Jakobi K; Institute for Diagnostic and Interventional Radiology, Rostock University Medical Center, Rostock, Germany.
Janisch M; Department of Radiology, University Hospital Graz, Austria.
Kocher N; Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany.
Kopp M; Institute of Radiology, University Hospitals Erlangen Department of Radiology, Erlangen, Germany.
Lennartz S; Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, Köln, Germany.
Martin O; Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf, Germany.
Moher Alsady T; Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
Pamminger M; Department of Radiology, Medical University Innsbruck Department of Radiology, Innsbruck, Austria.
Pedersoli F; Clinic for Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Germany.
Piechotta PL; Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Germany.
Platz Batista da Silva N; Institute of Diagnostic Radiology, University Hospital Regensburg, Germany.
Raudner M; University Clinic of Radiology and Nuclear Medicine, General Hospital of the City of Vienna-Hospital of the Medical University of Vienna, Wien, Austria.
Roehrich S; University Clinic of Radiology and Nuclear Medicine, General Hospital of the City of Vienna-Hospital of the Medical University of Vienna, Wien, Austria.
Schindler P; Clinic for Radiology, University Hospital Münster, Germany.
Schwarze V; Department of Radiology, Ludwig Maximilians University Munich, München, Germany.
Seppelt D; Department for Diagnostic and Interventional Radiology, University Hospital Carl Gustav Carus Dresden, Germany.
Sieren MM; Clinic for Radiology und Nuclear Medicine, University Medical Center Schleswig-Holstein Lübeck Campus, Lübeck, Germany.
Spurny M; Department for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany.
Starekova J; Department of Diagnostic and Interventional Radiology, University Hospital Hamburg-Eppendorf Center of Diagnostic, Hamburg, Germany.
Storz C; Neuroradiology, University Hospital Freiburg, Germany.
Wiesmüller M; Institute of Radiology, University Hospitals Erlangen Department of Radiology, Erlangen, Germany.
Zopfs D; Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, Köln, Germany.
Ringe KI; Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
Meyer BC; Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
Wacker FK; Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
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Transliterated Title:
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Phantomstudie zum Vergleich zwischen Computertomografie- und C-Arm-Computertomografie-gesteuertem Punktionsverfahren bei Anwendung durch Weiterbildungsassistenten in der Radiologie.
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Źródło:
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RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin [Rofo] 2022 Mar; Vol. 194 (3), pp. 272-280. Date of Electronic Publication: 2021 Nov 18.
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Typ publikacji:
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Journal Article
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Język:
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English; German
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Imprint Name(s):
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Original Publication: Stuttgart : Thieme
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MeSH Terms:
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Radiology*
Tomography, X-Ray Computed*/methods
Humans ; Phantoms, Imaging ; Punctures/methods ; Software
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Contributed Indexing:
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Local Abstract: [Publisher, German] ZIEL: Vergleich der Punktionsabweichung und -dauer zwischen Computertomografie (CT) – und C-Arm-CT (CACT) -gesteuertem Punktionsverfahren bei Anwendung durch Assistenzärzte in Weiterbildung (AiW). [Publisher, German] In einer Kohorte von 25 AiW, die Teil einer wissenschaftlichen Förderung waren, wurden entweder CT- oder CACT-gesteuerte Punktionen an einem Phantom durchgeführt. Vor Beginn wurden der Weiterbildungsstand, die Erfahrung mit Spielen eines Musikinstruments, mit Videospielen und mit Ballsportarten und die Selbsteinschätzung von manueller Geschicklichkeit und räumlichem Denkvermögen abgefragt. Jede/r AiW führte 2 Punktionen durch, wobei die 1. Punktion mit einem transaxialen bzw. einfach angulierten Nadelpfad und die 2. Punktion mit einem einfach bzw. doppelt angulierten Nadelpfad erfolgte. Punktionsabweichung und -dauer wurden zwischen den Verfahren verglichen und mit den Selbsteinschätzungen korreliert. [Publisher, German] Die beiden Gruppen der AiW zeigten keine Unterschiede in der Erfahrung in der Radiologie (p = 1), in der Angiografie (p = 0.415) und in der Anzahl bereits durchgeführter Punktionen gesteuert durch Ultraschall (p = 0,483), CT (p = 0,934) und CACT (p = 0,466). In der CT (ohne Navigationssoftware) war die Punktionsdauer signifikant länger als mit der CACT-Bildsteuerung mit Navigationssoftware (p < 0,001). Bei der Punktionsdauer zeigten sich keine signifikanten Unterschiede zwischen der 1. und 2. Punktion im CT (p = 0,719), während die 2. Punktion mit CACT schneller durchgeführt werden konnte (p = 0,006). Die Punktionsabweichung war weder signifikant zwischen CT- und CACT-Bildsteuerung (p = 0,337), noch zwischen der 1. und 2. Punktion der jeweiligen Verfahren (CT: p = 0,130; CACT: p = 0,391). Die Selbsteinschätzung der manuellen Geschicklichkeit korrelierte nicht mit der Punktionsabweichung (p = 0,059) und -dauer (p = 0,158). Das subjektive räumliche Denkvermögen zeigte eine moderate positive Korrelation zur Punktionsabweichung (p = 0,011), aber nicht zur -dauer (p = 0,541). [Publisher, German] Die AiW erreichten eine dem Ausbildungsstand entsprechende, klinisch adäquate Punktionsabweichung unter CT- und CACT-Bildsteuerung. Die CACT-gesteuerten Punktionen mit Unterstützung durch Navigationssoftware wurden schneller durchgeführt, und auch die Lernkurve war mit CACT-Bildsteuerung steiler. Räumliches Denkvermögen kann möglicherweise das Erlernen bildgesteuerter Punktionen beschleunigen. [Publisher, German] · Die Erfahrung mit Punktionen war in einer Gruppe von AiW, die im Rahmen des Programms der Deutschen Röntgengesellschaft e. V. „Forscher-für-die-Zukunft“ ausgesucht wurden, dem Weiterbildungsstand entsprechend.. · Trotz kollektiv geringerer Erfahrung der radiologischen AiW mit der CACT-gesteuerten Punktion mit Navigationssoftwareunterstützung ist die Lernkurve gegenüber der einfachen CT-Punktion möglicherweise steiler.. · Bei schwierigen Punktionswegen könnte die CACT-Bildsteuerung mit Softwareunterstützung einen Vorteil in der Durchführung gegenüber der konventionellen CT-Bildsteuerung haben.. [Publisher, German] · Meine TC, Hinrichs JB, Werncke T et al. Phantom study for comparison between computed tomography- and C-Arm computed tomography-guided puncture applied by residents in radiology. Fortschr Röntgenstr 2022; 194: 272 – 280.
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Entry Date(s):
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Date Created: 20211118 Date Completed: 20220331 Latest Revision: 20220401
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Update Code:
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20240105
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DOI:
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10.1055/a-1586-2733
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PMID:
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34794186
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Purpose: Comparison of puncture deviation and puncture duration between computed tomography (CT)- and C-arm CT (CACT)-guided puncture performed by residents in training (RiT).
Methods: In a cohort of 25 RiTs enrolled in a research training program either CT- or CACT-guided puncture was performed on a phantom. Prior to the experiments, the RiT's level of training, experience playing a musical instrument, video games, and ball sports, and self-assessed manual skills and spatial skills were recorded. Each RiT performed two punctures. The first puncture was performed with a transaxial or single angulated needle path and the second with a single or double angulated needle path. Puncture deviation and puncture duration were compared between the procedures and were correlated with the self-assessments.
Results: RiTs in both the CT guidance and CACT guidance groups did not differ with respect to radiologic experience (p = 1), angiographic experience (p = 0.415), and number of ultrasound-guided puncture procedures (p = 0.483), CT-guided puncture procedures (p = 0.934), and CACT-guided puncture procedures (p = 0.466). The puncture duration was significantly longer with CT guidance (without navigation tool) than with CACT guidance with navigation software (p < 0.001). There was no significant difference in the puncture duration between the first and second puncture using CT guidance (p = 0.719). However, in the case of CACT, the second puncture was significantly faster (p = 0.006). Puncture deviations were not different between CT-guided and CACT-guided puncture (p = 0.337) and between the first and second puncture of CT-guided and CACT-guided puncture (CT: p = 0.130; CACT: p = 0.391). The self-assessment of manual skills did not correlate with puncture deviation (p = 0.059) and puncture duration (p = 0.158). The self-assessed spatial skills correlated positively with puncture deviation (p = 0.011) but not with puncture duration (p = 0.541).
Conclusion: The RiTs achieved a puncture deviation that was clinically adequate with respect to their level of training and did not differ between CT-guided and CACT-guided puncture. The puncture duration was shorter when using CACT. CACT guidance with navigation software support has a potentially steeper learning curve. Spatial skills might accelerate the learning of image-guided puncture.
Key Points: · The CT-guided and CACT-guided puncture experience of the RiTs selected as part of the program "Researchers for the Future" of the German Roentgen Society was adequate with respect to the level of training.. · Despite the lower collective experience of the RiTs with CACT-guided puncture with navigation software assistance, the learning curve regarding CACT-guided puncture may be faster compared to the CT-guided puncture technique.. · If the needle path is complex, CACT guidance with navigation software assistance might have an advantage over CT guidance..
Citation Format: · Meine TC, Hinrichs JB, Werncke T et al. Phantom study for comparison between computed tomography- and C-Arm computed tomography-guided puncture applied by residents in radiology. Fortschr Röntgenstr 2022; 194: 272 - 280.
Competing Interests: Lorenz Biggemann: L. B. declares travel grant from Siemens Healthineers and speakers honorarium from Bristol Myer-Squibb unrelated to this project.Jan –Peter Grunz: J.-P. G. declares employment as “Research Consultant” at Siemens Healthineers unrelated to this project.Markus Kopp: M. B. declares participation at the Siemens Healthineers speakers’ bureau unrelated to this project.Simon Lennartz: S. L. declares institutional research support from Philips unrelated to this project.Timo C. Meine: T.C.M. declares passive participation at the BTG TheraSphere™ DACH Summit 2018 unrelated to this to this project.Bernhard C. Meyer: B.C.M. declares relationships with Siemens Healthcare and ProMedicus (outside the submitted work).Frank K. Wacker: F. K. W. declares relationships with Siemens Healthcare and ProMedicus (outside the submitted work).David Zopfs: D. Z. declares institutional research support from Philips Healthcare unrelated to this project.
(Thieme. All rights reserved.)
