Phantom study for comparison between computed tomography- and C-Arm computed tomography-guided puncture applied by residents in radiology
Authors: Meine Timo C. , Hinrichs Jan B. , Werncke Thomas , Afat Saif , Biggemann Lorenz , Bucher Andreas , Büttner Martina , Christner Sara , Dethlefsen Ebba , Engel Hannes , Gerwing Mirjam , Getzin Tobias , Gräger Stephanie , Gresser Eva , Grunz Jan-Peter , Harder Felix , Heidenreich Julius , Hitpaß Lea , Jakobi Kristina , Janisch Michael , Kocher Nadja , Kopp Markus , Lennartz Simon , Martin Ole , Moher Alsady Tawfik , Pamminger Matthias , Pedersoli Frederico , Piechotta Paula Louise , Platz Batista da Silva Natascha , Raudner Marcus , Roehrich Sebastian , Schindler Philipp , Schwarze Vincent , Seppelt Danilo , Sieren Malte M. , Spurny Manuela , Starekova Jitka , Storz Corinna , Wiesmüller Marco , Zopfs David , Ringe Kristina Imeen , Meyer Bernhard C. , Wacker Frank K. 
Published: November 2021

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.
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