Reduction of patient radiation dose during percutaneous CT vertebroplasty: Impact of a new computer-assisted navigation (CAN) system

Abstract

To assess the impact of a computer assisted navigation system (CAN) (CT-Navigation™ IMACTIS, France) on patient radiation doses during percutaneous CT vertebroplasty a retrospective comparative trial was performed and included 37 patients requiring percutaneous vertebroplasty. This study was approved by CCN (Centre Cardiologique du Nord, Saint-Denis, France) ethical committee; all patients provided informed consent. All procedures were conducted in the interventional radiology department at CCN, by an experienced single radiologist using the same model and CT scan with identical parameters. The interventional dose length product (IDLP), representing the absorbed dose by the length of explored organs during the needle insertion phase, was compared in 15 consecutive patients who underwent a conventional procedure (CT control group), and in 22 patients who underwent CAN CT vertebroplasty (CAN group). The IDLP difference between the two groups was evaluated using Mann–Whitney U test. The median IDLP dose for the CAN group was 305.6 mGy.cm [182.3; 565.4], representing a reduction by a 3.2 factor compared with that of the conventional CT group (median 975.2 mGy.cm [568.3; 1077.1]; p < 0.001). The median procedure duration for the CAN group was 50 min [35; 60] vs. 100 min [82; 100] in the CT group (p < 0.001), representing a 50% reduction. In experienced hands, use of a CT-Navigation™ system (IMACTIS®) significantly reduced both patient radiation dose and procedure duration when compared to conventional CT guided percutaneous vertebroplasty.

Computed Tomography-Navigation™ Electromagnetic System Compared to Conventional Computed Tomography Guidance for Percutaneous Lung Biopsy: A Single-Center Experience

“…The CT-Navigation™ system had already been studied for various procedures with a high rate of technical success [ 13 , 14 , 18 , 29 ], but the present study is the first study evaluating this system in the specific field of lung biopsies. An experiment similar to ours has been described by Grand et al comparing lung biopsies with CT-fluoroscopy guidance or with CT-fluoroscopy using an electromagnetic navigation system in 60 patients [ 12 ].…”

“…To our knowledge, six studies about the use of the CT-Navigation™ system on patients have been published [ 13 , 14 , 18 , 29 , 31 , 32 ]. Mavrovi et al’s retrospective study with 12 patients, the CT-Navigation™ system has been used as a guidance system for radiological percutaneous osteosynthesis and cementoplasty of malignant pathological fracture of the proximal femur [ 31 ].…”

“…A significant improvement of the accuracy was found with the use of the system, with a gain in accuracy remaining significant in both the easy and difficult intervention subgroups and in a subgroup analysis based on operator experience [ 13 ]. The retrospective study of Teriitehau et al focused on the radiation doses delivered to patients during percutaneous vertebroplasty [ 29 ]. With 15 consecutive patients who underwent a conventional CT guided procedure, and 22 patients who underwent a procedure with the use of the CT-Navigation™ system, a significant reduction in the DLP by a 3.2 factor was found.…”

Des doses patients excessives en scanographie : de nouvelles préoccupations

“…La dose scanner reçue par les enfants exposés peut être optimisée en suivant quelques principes pratiques de base (Malchair et Maccia, 2020). Les doses de rayonnements délivrées aux patients pendant les vertébroplasties percutanées peuvent être réduites de façon significative en utilisant un système de navigation assistée par ordinateur (Teriitehau et al, 2020). Les connaissances des manipulateurs de radiologie au sujet des doses délivrées aux patients ont été étudiées en Arabie Saoudite dans le cadre de la radioprotection (Aldhafeeri, 2020).De nouvelles préoccupations majeures au sujet des doses liées à l'utilisation du scanner sont apparues dans deux revues internationales récentes.…”

“…CT scanner dose can be optimized in children by following some basic and practical advices (Malchair and Maccia, 2020). Patient radiation dose during percutaneous CT vertebroplasty can be significantly reduced by using computer-assisted navigation (CAN) system (Teriitehau et al, 2020). As part of radiological protection, the radiographers' knowledge regarding patients' ionizing radiation doses has been evaluated in Saudi Arabia (Aldhafeeri, 2020).…”