Image-guidance and minimally invasive approaches have revolutionized the management of cancer. Navigation systems, devices and intra-procedural software are changing the way we practice interventional oncology 
The common denominator of all these procedures is the percutaneous needle insertion step.
Different imaging modalities are used to guide the needle through the body to the target, such as radiography, computed tomography (CT), ultrasound (US) and magnetic resonance imaging (MRI) [2-5]. CT guidance provides invaluable assistance [6-8] and has been shown to be more accurate than US-guided procedures.
Despite the aid supplied by CT guidance, focal lesions (Tumors, abscess, …) or collections in difficult locations are a challenge for skills interventional radiologist in your daily practice. These lesions adjacent or behind large vessels or vulnerable organs, such as colon, gallbladder, … need high accuracy approach to place the needle. An out-of-plane trajectory is necessary in the majority of cases which is associated with decreased needle placement accuracy, leading to trajectory errors which could cause perforation of neighbouring organs or insufficient treatment delivery. Furthermore, radiation exposure increases, particularly in complex procedures.
To minimize this problem a new electromagnetic navigation system for CT-guided interventional radiology procedures (IMACTIS-CT®) has been developed. The feasibility of oblique trajectories means that the number of possible needle trajectories is increased when using the navigation system compared with conventional CT guidance.
The accuracy of the IMACTIS-CT® Navigation system has previously been demonstrated by the results obtained in a monocentric, prospective, randomized, controlled clinical trial . Compared with the use of conventional guidance the use of the navigation system improved the needle placement accuracy (p < 0.001) and reduced the number of control CT scans acquired during the needle insertion (p = 0.01).
To accurately evaluate the clinical benefit of the device, it is necessary to test the navigation system within a wider medical community, with this propose an open, multicenter, prospective, randomized, controlled clinical trial has been designed in the thoraco-abdominal region