Summary

Advice

The technology described in this briefing is SimpliCT. It is a laser device used to guide non-vascular puncture procedures in which CT or cone‑beam CT imaging is used.
The innovative aspect of SimpliCT is that it is a standalone device that does not need a separate workstation, new software or to be integrated with existing imaging systems.
The intended place in therapy would be in addition to standard freehand puncture in people needing non-vascular procedures in which CT or cone‑beam CT imaging is used.
The main points from the evidence summarised in this briefing are from: 2 retrospective, comparative observational studies; 2 prospective, non-comparative observational studies; and 1 case report. The studies include a total of 151 patients having interventional radiology, of whom 100 had a SimpliCT-guided procedure. These studies do not report any clinical-effectiveness outcomes. Comparative evidence shows that fluoroscopy time using cone‑beam CT is reduced in non-vascular interventional procedures with SimpliCT laser guidance. However, comparative overall procedure time varies according to the clinical indication and procedure.
Key uncertainties around the evidence and technology are whether a reduction in fluoroscopy time has any meaningful radiation dose benefit for the operator or patient, and whether fewer needle passes result in less patient discomfort and fewer side effects from the procedure. In addition, the identified literature mostly describes the use of SimpliCT with cone‑beam CT guidance, which may not be generalisable to UK practice where it is rarely used for biopsy or drainage procedures.
The cost of SimpliCT is £27,845 per unit (exclusive of VAT). Although the resource impact depends on the clinical indication, it is likely to be greater than standard care because of the capital investment and overall procedure time needed.