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For planning of the access route, a CT scan of theregion of interest is performed first. The preliminary scan can be performed without contrast if a recent diagnostic study is available and the lesion is easily visible. In the chest, a nonenhanced CT scan (slice thickness 3mm or less) is also sufficient for detection of intrapulmonary lesions suitable for aspiration or punch biopsy. For suspect masses in the mediastinum and abdomen (intra- and retroperitoneal), a contrastenhanced CT scan is necessary for clear differentiation of parenchymal organs, intestines, and blood vessels. Focal lesions within parenchymal organs are usually visualized during the venous phase (scan delay 50–70 s). An additional arterial phase (scan delay approximately 30 s) scan should be obtained if arteries are present along the access path (e.g., parasternal access, internal mammary artery) and in hypervascularized lesions (e.g., hepatocellular carcinoma, metastases of renal cell carcinoma).
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