Abstract
Purpose: To prospectively evaluate the impact of C-arm CT on radiation exposure to hepatocellular carcinoma (HCC) patients treated by chemoembolization. Materials and Methods: Patients with HCC (N = 87) underwent digital subtraction angiography (DSA; control group) or combined C-arm CT/DSA (test group) for chemoembolization. Dose-area product (DAP) and cumulative dose (CD) were measured for guidance and treatment verification. Contrast agent volume and C-arm CT utility were also measured. Results: The marginal DAP increase in the test group was offset by a substantial (50%) decrease in CD from DSA. Use of C-arm CT allowed reduction of DAP and CD from DSA imaging (P =.007 and P =.017). Experienced operators were more efficient in substituting C-arm CT for DSA, resulting in a negligible increase (7.5%) in total DAP for guidance, compared with an increase of 34% for all operators (P =.03). For treatment verification, DAP from C-arm CT exceeded that from DSA, approaching that of conventional CT. The test group used less contrast medium (P =.001), and C-arm CT provided critical or supplemental information in 20% and 17% of patients, respectively. Conclusions: Routine use of C-arm CT can increase stochastic risk (DAP) but decrease deterministic risk (CD) from DSA. However, the increase in DAP is operator-dependent, thus, with experience, it can be reduced to under 10%. C-arm CT provides information not provided by DSA in 33% of patients, while decreasing the use of iodinated contrast medium. As with all radiation-emitting modalities, C-arm CT should be used judiciously.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1535-1543 |
| Number of pages | 9 |
| Journal | Journal of Vascular and Interventional Radiology |
| Volume | 22 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 2011 |
| Externally published | Yes |
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Keywords
- 3D
- CD
- cumulative dose
- DAP
- digital subtraction angiography
- dose-area product
- DSA
- HCC
- hepatocellular carcinoma
- maximum-intensity projection
- MIP
- peak skin dose
- PSD
- three-dimensional
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine
Cite this
Imaging guidance with C-arm CT : Prospective evaluation of its impact on patient radiation exposure during transhepatic arterial chemoembolization. / Kothary, Nishita; Abdelmaksoud, Mohamed H K; Tognolini, Alessia; Fahrig, Rebecca; Rosenberg, Jarrett; Hovsepian, David M.; Ganguly, Arundhuti; Louie, John D.; Kuo, William T.; Hwang, Gloria L.; Holzer, Alison; Sze, Daniel Y.; Hofmann, Lawrence V.
In: Journal of Vascular and Interventional Radiology, Vol. 22, No. 11, 11.2011, p. 1535-1543.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Imaging guidance with C-arm CT
T2 - Prospective evaluation of its impact on patient radiation exposure during transhepatic arterial chemoembolization
AU - Kothary, Nishita
AU - Abdelmaksoud, Mohamed H K
AU - Tognolini, Alessia
AU - Fahrig, Rebecca
AU - Rosenberg, Jarrett
AU - Hovsepian, David M.
AU - Ganguly, Arundhuti
AU - Louie, John D.
AU - Kuo, William T.
AU - Hwang, Gloria L.
AU - Holzer, Alison
AU - Sze, Daniel Y.
AU - Hofmann, Lawrence V.
PY - 2011/11
Y1 - 2011/11
N2 - Purpose: To prospectively evaluate the impact of C-arm CT on radiation exposure to hepatocellular carcinoma (HCC) patients treated by chemoembolization. Materials and Methods: Patients with HCC (N = 87) underwent digital subtraction angiography (DSA; control group) or combined C-arm CT/DSA (test group) for chemoembolization. Dose-area product (DAP) and cumulative dose (CD) were measured for guidance and treatment verification. Contrast agent volume and C-arm CT utility were also measured. Results: The marginal DAP increase in the test group was offset by a substantial (50%) decrease in CD from DSA. Use of C-arm CT allowed reduction of DAP and CD from DSA imaging (P =.007 and P =.017). Experienced operators were more efficient in substituting C-arm CT for DSA, resulting in a negligible increase (7.5%) in total DAP for guidance, compared with an increase of 34% for all operators (P =.03). For treatment verification, DAP from C-arm CT exceeded that from DSA, approaching that of conventional CT. The test group used less contrast medium (P =.001), and C-arm CT provided critical or supplemental information in 20% and 17% of patients, respectively. Conclusions: Routine use of C-arm CT can increase stochastic risk (DAP) but decrease deterministic risk (CD) from DSA. However, the increase in DAP is operator-dependent, thus, with experience, it can be reduced to under 10%. C-arm CT provides information not provided by DSA in 33% of patients, while decreasing the use of iodinated contrast medium. As with all radiation-emitting modalities, C-arm CT should be used judiciously.
AB - Purpose: To prospectively evaluate the impact of C-arm CT on radiation exposure to hepatocellular carcinoma (HCC) patients treated by chemoembolization. Materials and Methods: Patients with HCC (N = 87) underwent digital subtraction angiography (DSA; control group) or combined C-arm CT/DSA (test group) for chemoembolization. Dose-area product (DAP) and cumulative dose (CD) were measured for guidance and treatment verification. Contrast agent volume and C-arm CT utility were also measured. Results: The marginal DAP increase in the test group was offset by a substantial (50%) decrease in CD from DSA. Use of C-arm CT allowed reduction of DAP and CD from DSA imaging (P =.007 and P =.017). Experienced operators were more efficient in substituting C-arm CT for DSA, resulting in a negligible increase (7.5%) in total DAP for guidance, compared with an increase of 34% for all operators (P =.03). For treatment verification, DAP from C-arm CT exceeded that from DSA, approaching that of conventional CT. The test group used less contrast medium (P =.001), and C-arm CT provided critical or supplemental information in 20% and 17% of patients, respectively. Conclusions: Routine use of C-arm CT can increase stochastic risk (DAP) but decrease deterministic risk (CD) from DSA. However, the increase in DAP is operator-dependent, thus, with experience, it can be reduced to under 10%. C-arm CT provides information not provided by DSA in 33% of patients, while decreasing the use of iodinated contrast medium. As with all radiation-emitting modalities, C-arm CT should be used judiciously.
KW - 3D
KW - CD
KW - cumulative dose
KW - DAP
KW - digital subtraction angiography
KW - dose-area product
KW - DSA
KW - HCC
KW - hepatocellular carcinoma
KW - maximum-intensity projection
KW - MIP
KW - peak skin dose
KW - PSD
KW - three-dimensional
UR - http://www.scopus.com/inward/record.url?scp=80054902990&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80054902990&partnerID=8YFLogxK
U2 - 10.1016/j.jvir.2011.07.008
DO - 10.1016/j.jvir.2011.07.008
M3 - Article
VL - 22
SP - 1535
EP - 1543
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
SN - 1051-0443
IS - 11
ER -