Procedure-specific CT Dose and Utilization Factors for CT-guided Interventional Procedures

Abstract

Purpose To present procedure-specific radiation dose metric distributions and define quantitative CT utilization factors for CT-guided interventional procedures. Materials and Methods This single-center, retrospective study collected dictation reports and radiation dose data from 9143 consecutive CT-guided interventional procedures in adult patients from 2012 to 2017. Procedures were sorted into four major interventional categories: ablation, aspiration, biopsy, and drainage, each of which was further divided into subcategories. After exclusion, a total of 8213 procedures (4391 in men and 3822 in women) were divided into 21 subcategories. The mean patient age at examination for men was 62 years ± 15 (standard deviation; age range, 19-114 years), and for women it was 61 years ± 15 (age range, 19-113 years). Distributions of dose metrics and CT usage-related parameters were analyzed by category with descriptive statistic outcomes. Quantitative CT utilization factors (which measure average CT usage) for each interventional subcategory were derived by using total scan length, acquisition count, and number of images. Results Interventional CT scans have distinctly different dose metric characteristics from diagnostic CT scans. Wide variations of dose metrics were observed among subcategories, even within the same major category. For the most frequently performed CT-guided interventional procedures within each major category, liver ablation, chest aspiration, liver biopsy, and single abdominal drainage, the median dose-length product was 2351, 657, 1175, and 1125 mGy ∙ cm, respectively. Procedure-specific CT utilization factors ranged between 0.6 and 3.6. Conclusion This study provides procedure-specific CT dose metric distributions and quantitative CT utilization factors on the basis of a large number of procedures and categorization of CT-guided interventional procedures. © RSNA, 2018.

Enhanced In Vitro Biocompatibility and Water Dispersibility of Magnetite and Cobalt Ferrite Nanoparticles Employed as ROS Formation Enhancer in Radiation Cancer Therapy

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An interventional image‐guided microdevice implantation and retrieval method for in‐vivo drug response assessment

“…Image guidance selection is typically based on target site (e.g., tumor) visualization, radiation considerations, and user expertise/preference. If tumors and interventional devices are well seen on ultrasound, this is often preferred as it is usually faster and does not have the radiation exposure associated with CT . Conversely, some tumors are not well seen on US and procedures must be performed under CT guidance.…”

Radiation Dose in CT–guided Interventional Procedures: Establishing a Benchmark

“…This study by Yang et al (6) may have an important clinical impact on radiation dose management in CT-guided interventional procedures. Since radiation doses for these procedures are usually higher than for routine diagnostic examinations, it is critical to manage and optimize radiation dose to be as low as reasonably achievable.…”

“…Dose metric distributions for institutions that routinely use CT fluoroscopy and intermittent modes might be different from what was observed in this study. Because the study by Yang et al (6) was from a single institution, it would be beneficial to see similar investigations from other institutions to appreciate the variability among practices. Additionally, the timing of this kind of study is right.…”

“…In conclusion, radiation dose in CT-guided interventional procedures is usually higher than diagnostic tasks and has larger dose variation. Yang et al (6) provided detailed dose metric distributions of interventional procedures and presented this information by using procedure subcategories, which may encourage similar investigations at other institutions. With data that is more available and easier to follow, dose reference levels could be established at institutional or national levels to better manage radiation doses in CT-guided interventional procedures.…”