First experience of efficacy and radiation exposure in 320-detector row CT fluoroscopy-guided interventions

Abstract

Objective: We investigated the efficacy and exposure to radiation in 320-detector row computed tomography fluoroscopy-guided (CTF-guided) interventions. Methods: We analysed 231 320-detector row CTF-guided interventions (207 patients over 2 years and 6 months) in terms of technical success rates, clinical success rates, complications, scanner settings, overall radiation doses (dose–length product, mGy*cm), patient doses of peri-interventional CT series, and interventional CT (including CTF), as a retrospective cohort study. The relationships between patient radiation dose and interventional factors were assessed using multivariate analysis. Results: Overall technical success rate was 98.7% (228/231). The technical success rates of biopsies, drainages, and aspirations were 98.7% (154/156), 98.5% (66/67), and 100% (8/8), respectively. The clinical success rate of biopsies was 93.5% (146/156). All three major complications occurred in chest biopsies. The median total radiation dose was 522.4 (393.4–819.8) mGy*cm. Of the total radiation dose, 87% was applied during the pre- and post-interventional CT series. Post-interventional CT accounted for 24.4% of the total radiation dose. Only 11.4% of the dose was applied by CTF-guided intervention. Multilinear regression demonstrated that male sex, body mass index, drainage, intervention time, and helical scan as post-interventional CT were significantly associated with higher dose. Conclusion: The 320-detector row CTF interventions achieved a high success rate. Dose reduction in post-interventional CT provides patient dose reduction without decreasing the technical success rates. Advances in knowledge: This is the first study on the relationship between various interventional outcomes and patient exposure to radiation in 320-detector row CTF-guided interventions, suggesting a new perspective on dose reduction.

Reducing Time and Patient Radiation of Computed Tomography–guided Thoracic Needle Biopsies With Single-rotation Axial Acquisitions

“…21,35,36 Without this distinction, "CT fluoroscopy" may suggest high radiation exposure to the patient and operator as reported for needle manipulation during continuous imaging, a technique that is still in use today. 17,18,[37][38][39][40] While the effect of image acquisition mode on various CT-guided procedures has been reported, this is the first adequately powered study detailing the outcomes of TNBs guided by helical acquisitions compared with single-rotation acquisitions. 17,20,25,27 As such, the findings in this study extend those from prior reports.…”

“…Specifically, the distinction between continuous (live) image acquisition during needle manipulation and intermittent image acquisition in between needle adjustments is not always clear 21,35,36. Without this distinction, “CT fluoroscopy” may suggest high radiation exposure to the patient and operator as reported for needle manipulation during continuous imaging, a technique that is still in use today 17,18,37–40…”