National dose reference levels in computed tomography–guided interventional procedures—a proposal

Greffier, Joël; Ferretti, Gilbert; Rousseau, Julia; Andréani, Olivier; Alonso, Emilie; Rauch, Aymeric; Gillet, Romain; Roy, Julien Le; Cabrol-Faivre, Laurie; Douane, Frédéric; David, Arthur; Henry, Simon; Jacques, Thibaut; Stefanovic, Xavier; Decoux, E.; Lafay, F; Pilleul, F.; Couzon, Franck; Billen, Claire; Woerly, Bernard; Baur, Patrick; Sans, N.; Faruch, Marie; Moussier-Lherm, Aurélie; Tselikas, Lambros; Jacquier, Alexis; Bigand, Emeline; Pessis, É.; Tériitéhau, C.; Magnier, F; Cassagnes, L.; Haberlay, Marc; Boutteau, David; Kerviler, É. de; Majorel-Gouthain, Cynthia; Defez, Didier; Vuillod, Aurélie; Rouvière, Olivier; Hennequin, L.; Fohlen, Audrey; Alwan, Rabih; Malakhia, Alexandre; Aubry, S.; Dohan, Anthony; Eresue-Bony, Marie; Gautier, Romain; Dal, Romaric; Dabli, Djamel; Hébert, Thomas P.; Kovács, Róbert; Hadid-Beurrier, Lama; Bousson, Valérie; Potel, Mélody; Barbotteau, Y.; Michel, Célian; Habib-Geryes, Bouchra; André, M.; Arnaud, Thierry; Bestion, Nathalie; Ernst, Olivier; Monfraix, Sylvie; Brillet, Pierre Yves; Guiu, Boris; Boussel, Loîc; Demonchy, Mathilde; Beregi, Jean Paul; Frandon, Julien

doi:10.1007/s00330-020-06903-9

Cited by 9 publications

(15 citation statements)

References 15 publications

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“…However, one drawback of Imactis ® is that the use of helicoidal acquisition is mandatory. Indeed, optimization recommendations involve limiting the length and number of helicoidal acquisitions and preferring sequential or fluoroscopic acquisition when possible (1,(11)(12)(13). The greatest exposures occur during plan acquisition and final control, where helical mode contributed 82% of the total dose length product (DLP) in a recent multicentric study (13).…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, optimization recommendations involve limiting the length and number of helicoidal acquisitions and preferring sequential or fluoroscopic acquisition when possible (1,(11)(12)(13). The greatest exposures occur during plan acquisition and final control, where helical mode contributed 82% of the total dose length product (DLP) in a recent multicentric study (13). Some studies have proposed adapting mAs and kVp to patient size and diameter to help reduce the dose (30).…”

Section: Discussionmentioning

confidence: 99%

“…Considering the recent awareness of the cancer-inducing risks of radiation, dose optimization is currently an important issue (2)(3)(4)(5)(6)(7)(8)(9)(10). Regarding helical acquisitions, international practice guidelines for optimization recommend limiting their number and length (1,(11)(12)(13) and preferring sequential or fluoroscopic acquisitions when possible (3,7,10).…”

Section: Introductionmentioning

confidence: 99%

“…For complex procedures that require repetitive helicoidal acquisitions, which result in higher radiation doses delivered to the patients (13,14), many CT navigation systems have been developed to help radiologists improve the accuracy and safety of the procedure (15,16). Among them is the Imactis ® system, a computer-assisted navigation system that provides virtual electromagnetic guidance of the needle in a 3D space.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of acquisition and iterative reconstruction parameters in abdominal computed tomography-guided procedures: a phantom study

Frandon¹,

Akessoul²,

Hamard³

et al. 2022

Quant Imaging Med Surg

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Background: Many computed tomography (CT) navigation systems have been developed to help radiologists improve the accuracy and safety of the procedure. We evaluated the accuracy of one CT computer-assisted guided procedure with different reduction dose protocols.Methods: A total of 128 punctures were randomly made by two operators on two different anthropomorphic phantoms. The tube voltage was fixed to 100 kVp. Tube currents (mAs) were defined to obtain 4 dose levels: 180 mAs (D1.00), 90 mAs (D0.50), 45 mAs (D0.25) and 15 mAs (D0.10) with respective volume CT dose index (CTDIvol) of 7.02, 3.52, 1.75 and 0.59 mGy. The raw data were reconstructed using level 2 of advanced model-based iterative reconstruction (ADMIRE) (A2) for D1.00, A3 for D0.50, A4 for D0.25 and A5 for D0.10. Two 12-mm targets per phantom were selected. The mean Euclidean distance (EuD) between the tip of the needle and the isocenter of the target was measured for each puncture. The different measures were compared by paired Student's t-tests.Results: The mean EuD was 7.0±3.1 mm for the 128 punctures performed. Regardless of which phantom was considered, no significant difference in accuracy occurred between the 4 dose levels, which were 7.1±3.5 mm for D1.00; 7.1±3.1 mm for D0.50; 7.2±3.0 mm for D0.25 and 6.6±2.6 mm for D0.10.Conclusions: Abdominal CT-guided procedures, using computer-assisted navigation and iterative reconstruction algorithms, allow precise punctures on anthropomorphic phantoms with a dose reduction of −92% compared to a standard protocol.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of acquisition and iterative reconstruction parameters in abdominal computed tomography-guided procedures: a phantom study

Frandon¹,

Akessoul²,

Hamard³

et al. 2022

Quant Imaging Med Surg

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“…A radiofrequency wave causes ionic stirring and an increase in temperature in the tumor, resulting in immediate cell death by coagulation and necrosis, and delayed cell death by apoptosis [2]. The doses received by operators are within the recommended standards and do not represent a limit to the practice of RFA [3], according to recently published guidelines [4]. The first pulmonary RFA procedure was described in 2000 [5], and multiple studies have shown low rates of complications [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Description of morphological evolution of lung tumors treated by percutaneous radiofrequency ablation: long term follow-up of 100 lesions with chest CT

Habert

Bisceglie

Bartoli

et al. 2021

International Journal of Hyperthermia

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Purpose: Radiofrequency ablation (RFA) is a safe and effective minimally invasive treatment for pulmonary tumors. Patterns on chest computed tomography (CT) after RFA are classified into five types; however, the follow-up has not been fully described. The objectives of this study were to describe (1) the CT pattern 3 years after RFA and (2) its evolution over 7 years. Materials and methods: Lesions treated with RFA between 2009 and 2017 and with !3 years of follow-up CT data were included. Lesions with local recurrences were excluded from the study. The morphology of the ablation zone was classified as nodular, fibrotic, atelectatic, cavitary, and disappeared. Other initial anatomical parameters were recorded. Kruskal-Wallis or Chi-square tests were used to compare the groups. Results: One hundred lung RFA scars were included, and a retrospective longitudinal study was performed. Three years after RFA, nodular, fibrotic, atelectatic, and cavitary scars, and disappearance were observed in 49%, 36%, 5%, 3%, and 6% of the scars, respectively. Evolution over 7 years showed that the fibrosis, atelectasis, and disappearance remained stable over time, whereas 28% of nodular scars evolved into fibrotic scars. Additionally, 45% of cavitary scars evolved into nodular scars. Pleural contact was associated with disappearance, and the use of a 20-mm needle was associated with atelectasis. Conclusion: Follow-up after RFA showed that fibrosis, disappearance, and atelectasis remained stable over time. Nodular scars could evolve into fibrotic scars, and cavitary scars could evolve into nodular scars.

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The growing potential of diagnostic reference levels as a dynamic tool for dose optimization

Damilakis

Vassileva

2021

Physica Medica

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National dose reference levels in computed tomography–guided interventional procedures—a proposal

Cited by 9 publications

References 15 publications

Comparison of acquisition and iterative reconstruction parameters in abdominal computed tomography-guided procedures: a phantom study

Comparison of acquisition and iterative reconstruction parameters in abdominal computed tomography-guided procedures: a phantom study

Description of morphological evolution of lung tumors treated by percutaneous radiofrequency ablation: long term follow-up of 100 lesions with chest CT

The growing potential of diagnostic reference levels as a dynamic tool for dose optimization

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