Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Eur J Radiol. 2021 Jan;134:109367. doi: 10.1016/j.ejrad.2020.109367. Epub 2020 Nov 10.
To assess the radiation dose reduction capabilities and the image quality of a new C-arm system in comparison to a standard C-arm system.
Prospective, randomized, IRB approved two-arm trial design. 49 consecutive patients with primary or secondary liver cancer were treated with transarterial chemoembolization (TACE) on two different angiography units. 28 patients were treated on a conventional angiography unit B, 21 patients on unit A which provides improved hardware and optimized image processing algorithms. Dose area product (DAP) and fluoroscopy time were recorded. DSA image quality of all procedures was assessed on a four-rank-scale by two independent and blinded readers.
Both cohorts showed no significant differences with regard to patient characteristics, tumor burden and fluoroscopy time. The new system resulted in a statistically significant reduction of cumulative DAP of 72% compared to the old platform (median 76 vs. 269 Gy*cm2). Individually, Fluoro-DAP and DSA-DAP decreased by 48% and 77% (p = 0.012 and p < 0.01), respectively. No statistically significant differences in DSA image quality were found between the two imaging platforms.
The new C-arm system significantly reduced radiation exposure for TACE procedures without increased radiation time or negative impact on DSA image quality. The combination of optimized hardware and software yields the highest radiation dose reduction and is of utmost importance for patients and interventionalists.
评估新型 C 臂系统与标准 C 臂系统相比的辐射剂量降低能力和图像质量。
前瞻性、随机、IRB 批准的双臂试验设计。49 例原发性或继发性肝癌患者在两种不同的血管造影机上接受经动脉化疗栓塞术（TACE）治疗。28 例患者在常规血管造影机 B 上治疗，21 例患者在提供改进的硬件和优化的图像处理算法的 A 机上治疗。记录剂量面积乘积（DAP）和透视时间。由两位独立和盲法读者对所有手术的 DSA 图像质量进行四级评分评估。
两组患者的特征、肿瘤负荷和透视时间均无显著差异。与旧平台相比，新系统的累积 DAP 统计学显著降低了 72%（中位数 76 与 269 Gy*cm2）。单独来看，荧光透视 DAP 和 DSA-DAP 分别降低了 48%和 77%（p = 0.012 和 p < 0.01）。两种成像平台之间的 DSA 图像质量无统计学差异。
新型 C 臂系统可显著降低 TACE 手术的辐射暴露，而不会增加辐射时间或对 DSA 图像质量产生负面影响。优化的硬件和软件的结合可实现最高的辐射剂量降低，对患者和介入医师至关重要。
