CT plays complementary role to MR in preprocedural planning
Assessment of osseous etiologies of back/neck pain
Plan treatment approach
Best Practice Guidelines
CT scanners have wide detector arrays that enable increased coverage of patient anatomy in single rotation
When using CT guidance for pain management procedures, users should be cognizant of radiation dose
Image quality requirements for procedures are different from those for diagnostic CT procedures
Acquire images only of area necessary to perform the procedure
Reduce image quality (increase noise) wherever possible by acquiring images only of quality required to safely and accurately access target
Monitor radiation dose to both patient and operators
Be familiar with dose-reduction measures, such as tube current modulation and iterative image reconstruction
Number of different dose indices are used to quantify and describe radiation dose from CT examinations, including weighted CT dose index (CTDIw), dose-length product (DLP), volume CTDI (CTDIvol), size-specific dose estimate (SSDE), and effective dose (E)
Radiation dose associated with CT-guided pain management procedures is often at lower end of patient radiation doses that are normally encountered in diagnostic radiology
IMAGING ANATOMY
General Anatomic Considerations
Critical Anatomic Structures
Anatomic Relationships
ANATOMY IMAGING ISSUES
Key Concepts
Imaging Approaches
Imaging Protocols
Imaging Pitfalls
Normal Measurements
PATHOLOGIC ISSUES
General Pathologic Considerations
Selected References
Jones AK et al: Best practice guidelines for ct-guided interventional procedures. J Vasc Interv Radiol. 29(4):518-9, 2018
Leng S: Radiation dose in CT-guided interventional procedures: establishing a benchmark. Radiology. 289(1):158-9, 2018
Pravatà E et al: Operator radiation doses during CT-guided spine procedures. Clin Neurol Neurosurg. 173:105-9, 2018
Wang D: Image guidance technologies for interventional pain procedures: ultrasound, fluoroscopy, and CT. Curr Pain Headache Rep. 22(1):6, 2018
Yang K et al: Procedure-specific CT dose and utilization factors for CT-guided interventional procedures. Radiology. 289(1):150-7, 2018
Weininger M et al: Accuracy of CT guidance of lumbar facet joint block. AJR Am J Roentgenol. 200(3):673-6, 2013
Sarti M et al: Low-dose techniques in CT-guided interventions. Radiographics. 32(4):1109-19; discussion 1119-20, 2012
Lyders EM et al: A case of spinal cord infarction following lumbar transforaminal epidural steroid injection: MR imaging and angiographic findings. AJNR Am J Neuroradiol. 30(9):1691-3, 2009
Hoeft MA et al: Cervical transforaminal injection and the radicular artery: variation in anatomical location within the cervical intervertebral foramina. Reg Anesth Pain Med. 31(3):270-4, 2006
Tierney RT et al: Cervical spine stenosis measures in normal subjects. J Athl Train. 37(2):190-193, 2002
Wilson DA et al: John Caffey award. MR imaging determination of the location of the normal conus medullaris throughout childhood. AJR Am J Roentgenol. 152(5):1029-32, 1989
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging Anatomy
Anatomy Imaging Issues
Pathology Issues
TERMINOLOGY
Abbreviations
Computed tomography (CT)
Definitions
CT plays complementary role to MR in preprocedural planning
Assessment of osseous etiologies of back/neck pain
Plan treatment approach
Best Practice Guidelines
CT scanners have wide detector arrays that enable increased coverage of patient anatomy in single rotation
When using CT guidance for pain management procedures, users should be cognizant of radiation dose
Image quality requirements for procedures are different from those for diagnostic CT procedures
Acquire images only of area necessary to perform the procedure
Reduce image quality (increase noise) wherever possible by acquiring images only of quality required to safely and accurately access target
Monitor radiation dose to both patient and operators
Be familiar with dose-reduction measures, such as tube current modulation and iterative image reconstruction
Number of different dose indices are used to quantify and describe radiation dose from CT examinations, including weighted CT dose index (CTDIw), dose-length product (DLP), volume CTDI (CTDIvol), size-specific dose estimate (SSDE), and effective dose (E)
Radiation dose associated with CT-guided pain management procedures is often at lower end of patient radiation doses that are normally encountered in diagnostic radiology
IMAGING ANATOMY
General Anatomic Considerations
Critical Anatomic Structures
Anatomic Relationships
ANATOMY IMAGING ISSUES
Key Concepts
Imaging Approaches
Imaging Protocols
Imaging Pitfalls
Normal Measurements
PATHOLOGIC ISSUES
General Pathologic Considerations
Selected References
Jones AK et al: Best practice guidelines for ct-guided interventional procedures. J Vasc Interv Radiol. 29(4):518-9, 2018
Leng S: Radiation dose in CT-guided interventional procedures: establishing a benchmark. Radiology. 289(1):158-9, 2018
Pravatà E et al: Operator radiation doses during CT-guided spine procedures. Clin Neurol Neurosurg. 173:105-9, 2018
Wang D: Image guidance technologies for interventional pain procedures: ultrasound, fluoroscopy, and CT. Curr Pain Headache Rep. 22(1):6, 2018
Yang K et al: Procedure-specific CT dose and utilization factors for CT-guided interventional procedures. Radiology. 289(1):150-7, 2018
Weininger M et al: Accuracy of CT guidance of lumbar facet joint block. AJR Am J Roentgenol. 200(3):673-6, 2013
Sarti M et al: Low-dose techniques in CT-guided interventions. Radiographics. 32(4):1109-19; discussion 1119-20, 2012
Lyders EM et al: A case of spinal cord infarction following lumbar transforaminal epidural steroid injection: MR imaging and angiographic findings. AJNR Am J Neuroradiol. 30(9):1691-3, 2009
Hoeft MA et al: Cervical transforaminal injection and the radicular artery: variation in anatomical location within the cervical intervertebral foramina. Reg Anesth Pain Med. 31(3):270-4, 2006
Tierney RT et al: Cervical spine stenosis measures in normal subjects. J Athl Train. 37(2):190-193, 2002
Wilson DA et al: John Caffey award. MR imaging determination of the location of the normal conus medullaris throughout childhood. AJR Am J Roentgenol. 152(5):1029-32, 1989
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