PUNCTURE APPROACHES FOR PERCUTANEOUS CT-GUIDED MINI-INVASIVE INTERVENTIONS IN BONE TUMORS OF THE PELVIS
Aim: was to systematize and clarify possible puncture approaches in percutaneous CT-guided mini-invasive procedures in patients with tumor lesions of pelvic bones. Methods and materials: 63 CT-guided interventions were performed on pelvic bones (53 trephine biopsy and 10 cryoablations) in 52 patients. Manipulations were performed using the Philips Ingenuity CT scanner, Maxio Perfint robotic system and «Medical Cryotherapeutic System». Results: during interventional procedures, three topographic regions were identified - zones of the pelvic ring: upper zone (at the level of the ilium), middle zone (level of the articular space of the hip joint), and lower zone (at the level of the ramus of the ischial and pubic bones). In each zone, within certain safety sectors, puncture approaches are highlighted, associated with five optimal positions of the patient in the gantry aperture. Clinical examples of puncture procedures with various localization of the pathological process are given, demonstrating the safety of approaches and the validity of proposed recommendations. There were no complications after interventions. Conclusion: the choice of the optimal puncture approach and standard patient’ positions in miniinvasive CT-guided operations in patients with pelvic bone lesions can improve the efficiency and safety of surgical procedures.