COMPUTED TOMOGRAPHY-GUIDED PERCUTANEOUS BIOPSY: CRITERIA FOR ACCURATE NEEDLE TIP IDENTIFICATION

Precise localization of the needle tip during CT-guided percutaneous biopsy is considered to be a key element of a successful procedure. To ensure accuracy, the true needle tip must be differentiated from a false or simulated tip which appears when the CT slice encompasses only the shaft of an angled needle. By obtaining images of an aspiration biopsy needle inserted vertically into a phantom and then incrementally tilting the gantry, the authors were able to compare the characteristic features of the true tip to the simulated tip. The true tip was abrupt and distinct and had an adjacent flame-like low density artifact. The simulated tip was indistinct and tapered, yet still produced the adjacent artifact. We concluded that the shape and distinctness of the end portion of the needle itself, rather than the attendant artifact, were the most reliable criteria for accurate needle tip identification.