Abstract No. 585 Predictors of intrahepatic recurrence of hepatocellular carcinoma following percutaneous microwave ablation

Abstract

The purpose of this work was to evaluate the effect of new fluoroscopic imaging hardware and software on patient skin entrance exposure during common IR procedures. Materials and Methods: A retrospective review of patient entrance reference point (PERP) using an automated dose database Imalogix (Bryn Mawr, PA) was performed from January 1, 2020, to September 20, 2020. The data was sorted by imaging equipment used (Siemens Healthineers, Forchheim, GR) and procedure description according to the Radlex playbook. Cases from three Artis Q units were pooled, as were cases from two Pheno units that employ advanced new imaging chain hardware and software. Statistics from thirteen most common procedures (N > 9) were evaluated using box and whisker plots. Results: There were 1134 cases for the Artis Q platform, and 759 cases for the Pheno platform. The thirteen most common procedures ranged from tunnel central line placement (308), down to IVC filter placement (19). The maximum median PERP for the Atris Q systems was 1484 mGy (arterial embolization) and the minimum median PERP was 3 mGy (peripherally inserted central catheter placement). The maximum median PERP for the Pheno systems was 769 mGy (arterial embolization) and the minimum median PERP was 1 mGy (peripherally inserted central catheter placement). Median PERP on the Pheno platform was less than Artis Q for 11/13 (85%) procedures. Interquartile range for PERP was less on the Pheno platform than Artis Q for 12/13 (92%) procedures. The average decrease in PERP on the Pheno platform was 46% for all procedures lower than Artis Q. Conclusions: Use of improved imaging hardware and software can reduce patient PERP by 46% for a range of common procedures. Future work needs to be performed to understand patient habitus, platform default dose rates and image quality to understand the dose reduction.