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) |
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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 |
Keywords
- 3D
- CD
- DAP
- DSA
- HCC
- MIP
- PSD
- cumulative dose
- digital subtraction angiography
- dose-area product
- hepatocellular carcinoma
- maximum-intensity projection
- peak skin dose
- three-dimensional
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine