Navigation Systems Significantly Improve the Efficiency and Safety of CT-Guided Interventions.

Objectives

CT-guided interventions are associated with radiation exposure, prolonged procedural time, and complications. Navigation systems (NS) have been developed to improve procedural precision and efficiency. This study aimed to evaluate the impact of NS on procedural outcomes, radiation dose, and complication rates compared with conventional freehand techniques. Materials and methods: A systematic review and meta-analysis was performed including 30 studies (11 randomized controlled trials, 19 cohort studies) published through November 2023, involving 2785 patients (1418 NS; 1367 control). Outcomes included the number of needle manipulations, procedural time, radiation dose, complication rates, technical success, and diagnostic success. Random-effects models were applied with subgroup analyses by study design, intervention type, and target organ. Risk of bias was assessed using RoB 2 and ROBINS-I, and certainty of evidence using the GRADE framework.

Results

Navigation systems significantly reduced needle manipulations (mean difference [MD], -2.58; 95% CI: -3.30 to -1.85) and procedural time (MD, -8.07 min; 95% CI: -12.27 to -3.87). Radiation dose decreased by 37% (ratio of means [ROM], 0.63; 95% CI: 0.58-0.69). Complication rates were lower overall (odds ratio [OR], 0.64), with fewer chest tube insertions during lung ablations (OR, 0.58; 95% CI: 0.39-0.86). Diagnostic success improved (OR, 1.66; 95% CI: 1.01-2.73), whereas technical success was comparable (OR, 1.41; 95% CI: 0.89-2.24).

Conclusions

Navigation systems significantly enhance the efficiency and safety of CT-guided interventions by reducing needle manipulations, radiation exposure, and complication rates, while improving diagnostic success.