{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T23:56:35Z","timestamp":1776210995928,"version":"3.50.1"},"reference-count":30,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2010,10,5]]},"published-print":{"date-parts":[[2011,6]]},"abstract":"<jats:sec><jats:title>Background and aim<\/jats:title><jats:p>Accurate direct puncture access to vascular malformations and tumors of the head and neck is critical to successful embolization treatment and avoidance of complications. The primary focus of this project was to evaluate the accuracy and ease of needle placement using integrated 3D cone-beam CT and fluoroscopic guidance in accessing head and neck vascular malformations and tumors, and to determine its contribution to lesion treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 27 patients, 14 female and 13 male, aged 4\u201363\u2005years, were included in this study. The lesions included 11 venous malformations, 5 arteriovenous malformations, 5 juvenile nasopharyngeal angiofibromas, 2 lymphovenous malformations, 1 lymphatic malformation, 1 capillary malformation, 1 nasal cavity leiomyoma, and 1 dural arteriovenous fistula. A total of 65 needle placements in 33 procedures were performed using an integrated 3D cone-beam CT and fluoroscopic guidance system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Targeting was successful with a single pass in 62 of 65 planned needle placements to a superficial location in 24, the hypopharynx, retro-pharyngeal, pyriform sinus, or paratracheal spaces in 21, the sphenoid sinus and upper nasal cavity via trans-nasal approach in 5, intra-orbital in 5, intra-laryngeal in 4, pterygo-palatine fossa in 4, external auditory canal in 1, and intracranial via a juxta-torcular burr hole in 1. Needle placement was within 2\u2005mm of the planned target in 11 locations in the 8 patients where post needle-placement cone-beam CT was obtained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This integrated 3D cone-beam CT and fluoroscopic guidance allowed access to deep, difficult to access, locations with ease using a single needle pass in most cases, resulting in improved treatment with decreased procedure times.<\/jats:p><\/jats:sec>","DOI":"10.1136\/jnis.2010.003376","type":"journal-article","created":{"date-parts":[[2010,12,18]],"date-time":"2010-12-18T01:53:33Z","timestamp":1292637213000},"page":"186-190","source":"Crossref","is-referenced-by-count":21,"title":["Integrated cone-beam CT and fluoroscopic navigation in treatment of head and neck vascular malformations and tumors"],"prefix":"10.1136","volume":"3","author":[{"given":"Gary M","family":"Nesbit","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric G","family":"Nesbit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bronwyn E","family":"Hamilton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2010,12,16]]},"reference":[{"key":"2024052223065658000_3.2.186.1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.154.1.2104689"},{"key":"2024052223065658000_3.2.186.2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1990.01870080079020"},{"key":"2024052223065658000_3.2.186.3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/BF00176941","article-title":"Modern imaging techniques and ultrasound-guided aspiration cytology for the assessment of neck node metastases: a prospective comparative study","volume":"250","author":"van den Brekel","year":"1993","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"2024052223065658000_3.2.186.4","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1148\/radiology.193.3.7972797","article-title":"Biopsy of parapharyngeal space lesions","volume":"193","author":"Yousem","year":"1994","journal-title":"Radiology"},{"key":"2024052223065658000_3.2.186.5","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1288\/00005537-199406000-00005","article-title":"Ultrasonography and ultrasound-guided fine-needle aspiration biopsy of head and neck lesions: a surgical perspective","volume":"104","author":"McIvor","year":"1994","journal-title":"Laryngoscope"},{"key":"2024052223065658000_3.2.186.6","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1148\/radiol.2241010602","article-title":"Head and lymphadenopathy: evaluation with US-guided cutting-needle biopsy","volume":"224","author":"Screaton","year":"2002","journal-title":"Radiology"},{"key":"2024052223065658000_3.2.186.7","doi-asserted-by":"crossref","first-page":"267","DOI":"10.2214\/ajr.181.1.1810267","article-title":"Sonography and sonographically guided fine-needle aspiration biopsy of the thyroid gland: indications and techniques, pearls and pitfalls","volume":"181","author":"Titton","year":"2003","journal-title":"AJR Am J Roentgenol"},{"key":"2024052223065658000_3.2.186.8","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.7863\/jum.2009.28.12.1679","article-title":"How diagnostic is ultrasound-guided neck mass biopsy (fine-needle capillary sampling biopsy technique)?: evaluation of 132 nonthyroid neck mass biopsies with pathologic analysis over 7 years at a single institution","volume":"28","author":"Lee","year":"2009","journal-title":"J Ultrasound Med"},{"key":"2024052223065658000_3.2.186.9","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1148\/radiology.171.2.2704815","article-title":"CT-guided fine-needle aspiration","volume":"171","author":"Welch","year":"1989","journal-title":"Radiology"},{"key":"2024052223065658000_3.2.186.10","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1148\/radiology.182.2.1732985","article-title":"Lesions of the foramen ovale: CT-guided fine needle aspiration","volume":"182","author":"Barakos","year":"1992","journal-title":"Radiology"},{"key":"2024052223065658000_3.2.186.11","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1055\/s-2008-1058926","article-title":"Computed tomography-guided aspirations of parapharyngeal and skull base masses","volume":"5","author":"Yousem","year":"1995","journal-title":"Skull Base Surg"},{"key":"2024052223065658000_3.2.186.12","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1001\/archotol.124.10.1155","article-title":"Image-guided fine-needle aspiration of the head and neck; five years' experience","volume":"124","author":"Sack","year":"1998","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"2024052223065658000_3.2.186.13","first-page":"1603","article-title":"CT-guided aspirations in the head and neck: assessment of the first 216 cases","volume":"25","author":"Sherman","year":"2004","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024052223065658000_3.2.186.14","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1148\/radiology.170.2.2911679","article-title":"Head and neck lesions: MR-guided aspiration biopsy","volume":"170","author":"Duckwiler","year":"1989","journal-title":"Radiology"},{"key":"2024052223065658000_3.2.186.15","doi-asserted-by":"publisher","DOI":"10.1097\/00004728-199811000-00030"},{"key":"2024052223065658000_3.2.186.16","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.2214\/ajr.170.6.9609180","article-title":"Interactive MR imaging-guided biopsy and aspiration with a modified clinical C-arm system","volume":"170","author":"Lewin","year":"1998","journal-title":"AJR Am J Roentgenol"},{"key":"2024052223065658000_3.2.186.17","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1002\/jmri.1880020117","article-title":"MR-guided aspiration cytology in the head and neck at high field strength","volume":"2","author":"Hathout","year":"1992","journal-title":"J Magn Reson Imaging"},{"key":"2024052223065658000_3.2.186.18","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1148\/radiol.2332031213","article-title":"Low-flow vascular malformations: MR-guided percutaneous sclerotherapy in qualitative and quantitative assessment of therapy and outcome","volume":"233","author":"Boll","year":"2004","journal-title":"Radiology"},{"key":"2024052223065658000_3.2.186.19","first-page":"71","article-title":"Extra- to intracranial arterial anastomoses in therapeutic embolization: recognition and role","volume":"1","author":"Ahn","year":"1980","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024052223065658000_3.2.186.20","first-page":"1233","article-title":"Devascularization of craniofacial tumors by percutaneous tumor puncture","volume":"15","author":"Casasco","year":"1994","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024052223065658000_3.2.186.21","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199911000-00028"},{"key":"2024052223065658000_3.2.186.22","first-page":"179","article-title":"Major complications of percutaneous embolization of skull-base tumors","volume":"20","author":"Casasco","year":"1999","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024052223065658000_3.2.186.23","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199907000-00001"},{"key":"2024052223065658000_3.2.186.24","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1148\/radiology.211.3.r99jn07661","article-title":"Craniofacial arteriovenous malformation: preoperative embolization with direct puncture and injection of n-butyl cyanoacrylate","volume":"211","author":"Han","year":"1999","journal-title":"Radiology"},{"key":"2024052223065658000_3.2.186.25","first-page":"1457","article-title":"Intratumoral injection of cyanoacrylate glue in head and neck paragangliomas","volume":"25","author":"Abud","year":"2004","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024052223065658000_3.2.186.26","first-page":"1453","article-title":"Direct puncture embolization for paragangliomas: promising results but preliminary data","volume":"25","author":"Derdeyn","year":"2004","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024052223065658000_3.2.186.27","doi-asserted-by":"crossref","first-page":"160","DOI":"10.3171\/jns.1999.90.1.0160","article-title":"Accuracy of true frameless steroetaxy:in vivo measurement and laboratory phantom studies. Technical note","volume":"90","author":"Dorward","year":"1999","journal-title":"J Neurosurg"},{"key":"2024052223065658000_3.2.186.28","doi-asserted-by":"crossref","unstructured":"Cooke DL Levitt M Kim LK . Transcranial Access Using Fluoroscopic Cone-Beam CT Navigation, ASNR Annual Meeting Proceedings, 2010:P104.","DOI":"10.3174\/ajnr.A2066"},{"key":"2024052223065658000_3.2.186.29","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.media.2005.04.012","article-title":"Accuracy evaluation of direct navigation with an isocentric 3D rotational X-ray system","volume":"10","author":"van de Kraats","year":"2006","journal-title":"Med Image Anal"},{"key":"2024052223065658000_3.2.186.30","unstructured":"Nguyen AD Park MS Hung ST . Image-guided stereotactic embolization of extracranial vascular anomalies \u2013 early experience, WNRS Annual Meeting Proceedings, 2008:P165."}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jnis.2010.003376","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T07:13:56Z","timestamp":1716448436000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/jnis.2010.003376"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,12,16]]},"references-count":30,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2011,5,6]]},"published-print":{"date-parts":[[2011,6]]}},"alternative-id":["10.1136\/jnis.2010.003376"],"URL":"https:\/\/doi.org\/10.1136\/jnis.2010.003376","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"value":"1759-8478","type":"print"},{"value":"1759-8486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,12,16]]}}}