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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; Alsady, Tawfik Moher; Pamminger, Matthias; Pedersoli, Frederico; Piechotta, Paula Louise; Pltz Batista da Silva, Natascha; Raudner, Marcus; Röhrich, Sebastian; Schindler, Philipp; Schwarze, Vincent; Seppelt, Danilo; Sieren, Malte M.; Spurny, Manuela; Starekova, Jitka; Storz, Corinna; Wiesmueller, Marco; Zopfs, David; Ringe, Kristina Imeen; Meyer, Bernhard C. and Wacker, Frank K. (2022): Phantom study for comparison between computed tomography- and C-Arm computed tomography-guided puncture applied by residents in radiology. In: Röfo : Fortschritte Auf Dem Gebiet der Röntgenstrahlen und der Bildgebenden Verfahren, Vol. 194, No. 3: pp. 272-280

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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.

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