Canceled or aborted CT-guided interventions: 13-year clinical experience at a tertiary care center

ObjectiveTo determine the frequency and causes of canceled or aborted CT-guided interventions (biopsies, cytological aspirations, hookwire localizations, and catheter drainages), associations with patient and procedural variables, and subsequent management.MethodsThis study included 3052 consecutive CT-guided interventions (2487 biopsies, 80 cytological aspirations, 223 hookwire localizations, and 262 catheter drainages) performed in a single institution within a 13-year period.ResultsFifty-two of 3052 CT-guided interventions were canceled or aborted, corresponding to a frequency of 1.7% (95% confidence interval [CI] 1.3-2.2%). Main causes in order of decreasing frequency included pain, lack of a safe window for intervention, impossibility to position the co-axial or biopsy needle in or near the target, inability to lie still, dyspnea and low oxygen saturation levels, non-discontinuation of anticoagulant therapy, impossibility to aspirate fluid or pus when attempting drainage, and impossibility to advance the drainage catheter in a fluid collection or abscess. On multivariate analysis, only catheter drainages and head-neck interventions were significantly at risk (p=0.019 and p=0.004) to be canceled or aborted, with odds ratios of 2.677 (95% CI 1.178-6.083) and 6.956 (95% CI 1.883-25.691), respectively. Of 52 canceled or aborted CT-guided interventions, 14 (26.9%) were repeated, 19 (36.5%) underwent a different non-CT-guided interventional procedure on the same target, and 19 (36.5%) did not undergo any subsequent intervention.ConclusionThe frequency of canceled or aborted CT-guided interventions is low, but is not negligible. Awareness of causes and circumstances under which they are more likely to occur may reduce the number of canceled or aborted CT-guided interventions.Key Points center dot Approximately 1.7% of CT-guided interventions, for which the patient physically shows up at the CT room and which are considered useful by the radiologist, are eventually canceled or aborted.center dot Main causes (of which some may be prevented) are pain, lack of a safe window, impossibility to position the co-axial or biopsy needle, inability to lie still, dyspnea, non-discontinuation of anticoagulant therapy, and impossibility to aspirate liquid or advance the catheter when attempting drainage.center dot CT-guided catheter drainages and head-neck interventions are particularly prone to being canceled or aborted.