Website is intended for physicians



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.




1.     Garnon J, Koch G, Caudrelier J, et al. Expanding the borders: Image-guided procedures for the treatment of musculoskeletal tumors. Diagnostic and Interventional Imaging. 2017; 98(9): 635-644.

2.     Sun G, Jin P, Liu XW, et al. Cementoplasty for managing painful bone metastases outside the spine. European Radiology. 2014; 24(3): 731-737.

3.     Burovik IA, Prokhorov GG, Lushina PA, et al. CT-guided robotic-assisted percutaneous interventions: first experience. Medical Visualization. 2019; (2): 27-35 [In Russ].

4.     Lin YC, Wu JS, Kung JW. Image guided biopsy of musculoskeletal lesions with low diagnostic yield. Current Medical Imaging Reviews. 2017; 13(3): 260-267.

5.     Miranda OM, Moser TP. A practical guide for planning pelvic bone percutaneous interventions (biopsy, tumour ablation and cementoplasty). Insights into Imaging. 2018; 9: 275-285.

6.     Coleman RE, Croucher PI, Padhani AR, et al. Bone metastases. Nature Reviews Disease Primers. 2020; 6: 83.

7.     Filippiadis DK, Charalampopoulos G, Mazioti A, et al. Bone and Soft-Tissue Biopsies: What You Need to Know. Seminars in Interventional Radiology. 2018; 35(4): 215-220.

8.     Veltri A, Bargellini I, Giorgi L, et al. CIRSE guidelines on percutaneous needle biopsy (PNB). CardioVascular and Interventional Radiology. 2017; 40(10): 1501-1513.

9.     Meagan C, Keegan BA, Darcy AK. Fine-needle aspiration biopsy for the diagnosis of bone and soft tissue lesions: a systematic review and meta-analysis. Journal of the American Society of Cytopathology. 2020; 9(5): 429-441.

10.   Barrientos-Ruiz I, Ortiz-Cruz EJ, Serrano-Montilla J, et al. Are Biopsy Tracts a Concern for Seeding and Local Recurrence in Sarcomas? Clinical Orthopaedics and Related Research. 2017; 475(2): 511-518.

11.   Burovik IA, Prokhorov GG. Computed tomography as a method of control of percutaneous tumor cryoablation. Diagnostic radiology and radiotherapy. 2019; (4): 57-65 [In Russ]. (АНГИОЛОГИЯ.ру) - портал о диагностике и лечении заболеваний сосудистой системы