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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2026; 36(01): 012-020
DOI: 10.1055/s-0045-1807747
Review Article

Image-Guided Percutaneous Spinal Biopsy: CT or C-Arm Guidance?

Authors

  • Sonal Saran 

    1   Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, Uttarakhand, India

  • Nishith Kumar

    2   Department of Radiodiagnosis and Interventional Radiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

  • Simran Suri

    3   SGT Medical College, Hospital, and Research Institute, Gurugram, Haryana, India

  • Tankeshwar Boruah

    4   Central Institute of Orthopaedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

  • Geetika Khanna

    5   Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

  • Sonam Kaur Walia

    6   Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India

  • Dharmendra Kumar Singh 

    2   Department of Radiodiagnosis and Interventional Radiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

Funding None.
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Abstract

Image-guided percutaneous spinal biopsy is a minimally invasive procedure for histopathological confirmation and/or microbiological assessment of spinal lesions. When considering image-guided percutaneous spinal biopsy, both computed tomography (CT) and C-arm guidance have their advantages and specific applications. CT provides high-resolution cross-sectional images, allowing for precise localization of lesions and thus, effective for biopsy of spinal lesions in complex anatomical locations (e.g., cervical and upper dorsal spine). However, patients may receive higher doses of radiation than those with C-arm. C-arm guidance offers continuous imaging, which can enhance needle placement accuracy and is typically associated with lower radiation exposure than CT. However, C-arm provides less detailed images compared with CT, especially for certain lesions, and can be more challenging for accessing certain spinal areas, especially in the presence of anatomical variations. The choice between CT and C-arm guidance often depends on the specific clinical scenario, the location of the lesion, and the preferences of the clinician. For lesions that are easily accessible (lumbar, lower dorsal spine) and require real-time monitoring, C-arm may be preferred. For deeper or more complex lesions, CT guidance often provides better visualization and accuracy. Ultimately, the decision should be tailored to each patient's needs and the expertise of the clinician. This review article aims to compare the use of CT and C-arm guidance in percutaneous spinal biopsy, focusing on their technical aspects, diagnostic accuracy, and safety profiles.

Keywords

CT-guided spinal biopsy - C-arm guided spinal biopsy - vertebral biopsy - transpedicular vertebral biopsy


Publication History

Article published online:
04 June 2025

© 2025. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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