Fundamental Procedural Radiology Peri-Procedural Tasks: Procedural Indications


For any radiology procedure there are indications which serve as a guideline as to why the procedure in question should be done. The indications are often specific to the procedure in question, however there are some elements of procedural radiology indications that are more universal and will be covered on this page.

Whenever a procedure is ordered it is important to answer the question “why should this procedure be done?” (image source).

While procedural indications can get nuanced at times, the main question that needs to be answered before planning a procedure is “Why should this radiology procedure be performed?”.  Many procedures in theory can be conducted, and in the realm of medical procedures are often less invasive for patients, however there should always be a clear answer to the prior question because no procedure is without risk.  Here are some major themes for indications that apply to numerous radiology procedures:

Image guidance is required/failed procedure attempt without image guidance:

Certain radiology procedures are performed by other specialties without or with less limited imaging guidance (paracentesis, lumbar puncture, certain joint injections, etc.) A common theme for indications can be that a procedure is so technically challenging that an attempt by another specialty has already been unsuccessful, is very likely to be unsuccessful, or is dangerous. Here are some examples:

  • A paracentesis under continuous ultrasound guidance for a small collection of ascites 
  • Placement of a PICC line using ultrasound guidance after multiple attempts by a bedside PICC team
  • A CT guided lumbar puncture after an unsuccessful attempt by neurology 

The patient is a poor surgical candidate:

Given that certain patients have many co-morbidities that increase the risk of undergoing general anesthesia and a surgical procedure, coupled with the fact that radiology procedures are generally less invasive and less morbid to patients, often times a contraindication to surgery may serve as an indication for a radiology procedure. Here are some examples:

  • Placement of a cholecystectomy tube into a gall bladder of a patient with acute cholecystitis who is too ill to undergo an acute cholecystectomy. 



Page Updated: 04.14.19