Needle Detection software improves procedural efficiency and reduces verification scans in CT-guided needle placement: a multi-operator phantom study

Abstract Purpose To assess the impact of a dedicated Needle Detection software tool on procedural efficiency and radiation-related surrogate parameters during CT-guided needle placement in a controlled, multi-operator phantom study. Materials and methods Ten radiologists performed a total of 60 CT-guided needle insertions in a torso phantom using a randomized, balanced study design (30 procedures with Needle Detection activated and 30 without). Needle Detection software is an automated image-processing algorithm that identifies, enhances, and continuously tracks the needle shaft and tip on CT images, thereby improving visual guidance during needle advancement. Primary outcomes were time to target and verification scans, defined as the number of CT verification scans performed during needle progression. Time to target was compared using the Mann–Whitney U test, while number of verification scans was analyzed using a permutation test with 10,000 iterations. Results Needle Detection significantly improved procedural performance. Mean time to target decreased from 422.5 ± 199.8 s without Needle Detection to 224.3 ± 103.3 s with Needle Detection, corresponding to an approximate 47% reduction in procedure time ( p < 0.001). The number of verification scans required during needle advancement was also significantly reduced, with a median of 4 (IQR: 3–6) without Needle Detection compared with 3 (IQR: 2–4) with Needle Detection ( p < 0.0001). Improvements in both procedural time and verification scans were observed consistently across all participating operators. Conclusion Needle Detection software significantly improved procedural efficiency during CT-guided needle placement in this randomized phantom study and was associated with fewer verification scans. Because radiation dose was not measured directly, these findings should not be interpreted as evidence of reduced patient radiation dose. Further clinical studies including direct radiation dosimetry are warranted.