CTF guidance

Fig. 37.4a,b. Patient (supine position) with multiple hepatic rim-enhancing lesions in both liver lobes (preinterventional CT, venous phase) (a). An easy-to-access lesion in segment 3 was chosen for Tru-Cut biopsy with al6-G(10cm) needle under CTF guidance (b). Histopathology revealed hepatic metas-tases of gall bladder carcinoma... 

Fig. 37.6. Patient (prone position) with suspect mass of the right psoas muscle. A posterior paravertebral (5th lumbar vertebra) access was chosen for Tru-Cut biopsy with an 18-G (13 cm) needle under CTF guidance. Histopathology revealed metastasis of ovarian carcinoma...

Fig. 37.7a,b. Patient (supine position) with a history of diffuse large B-cell lymphoma (DLCL). Preinterventional CT showed a moderately enhancing nodule (large arrow) next to the iliac vessels (small arrows) (a). The 18-G (13 cm) Tru-Cut biopsy needle was introduced under CTF guidance next to the left iliac crest through the peritoneal fat (b). Histopathology revealed recurrence of DLCL... 

Fig. 37.10a,b. Patient with spondylodiscitis and bilateral psoas abscesses. With a lateral approach along the iliac crest (a), an 8-French drainage catheter was placed in both abscesses under CTF guidance using the Trocar technique (b)... 

A series of orders and plans established the general command and control structure of the CTF. These orders and plans also transmitted sufficient authority and guidance to subordinate component conunands and operational units so that they could then develop the local procedures that were necessary to bridge the gap between general mission orders and specific subunit operations. 

To prevent friendly fire accidents, pilots need to know exactly what friendly aircraft are flying in the no-fly zone at all times as well as know and follow the ROE and other procedures for preventing such accidents. The higher levels of control delegated the authority and guidance to develop local procedures to the CTF level and below. These local procedures included ... 

According to the official accident report, the contents of the ACO largely reflected the guidance given in the operations plan dated September 7,1991. But that was the plan provided before the mission had changed. The accident report concludes that key CTF personnel at the time of the accident were either unaware of the existence of this particular plan or considered it too outdated to be applicable. The acddent report states, Most key personnel within the CFAC and CTF staff did not consider... 

In comparison to conventional CT guidance, the advantage of CTF is the online visualization, the excellent resolution of bone, and the surrounding soft tissue and the possibility to target even small lesions (Daly and Templeton 1999). The very good resolution of bone and soft tissue is furthermore able to reduce the amount of complications due to misplacement of the needle. 

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