PURPOSE: We investigated the benefit of real-time guidance of interventional punctures by means of computed tomography fluoroscopy (CTF) compared with the conventional sequential acquisition guidance. MATERIAL AND METHODS: In a prospective randomized trial, 75 patients underwent either CTF-guided (group A,n=50) or sequential CT-guided (group B,n=25) punctures of thoracic (n=29) or abdominal (n=46) masses. CTF was performed on the CT machine (Somatom Plus 4 Power, Siemens Corp., Forchheim, Germany) equipped with the C.A.R.E. Vision application (tube voltage 120kV, tube current 50mA, rotational time 0.75s, slice thickness 10mm, 8 frames/s). RESULTS: The average procedure time showed a statistically significant difference between the two study groups (group A: 564s, group B 795s,P=0.0032). The mean total mAs was 7089mAs for the CTF and 4856mAs for the sequential image-guided intervention, respectively. The sensitivity was 71% specificity 100% positive predictive value 100% and negative predictive value 60% for the CTF-guided puncture, and 68, 100, 100 and 50% for sequential CT, respectively. CONCLUSION: CTF guidance realizes a time-saving but increases the radiation exposure dosage .Kirchner, J. et al. (2002) Clinical Radiology57, 188–192