Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, 1838 Ishikawa-machi, Hachioji, Tokyo, Japan.
Department of Radiological technology, Tokai University Hachioji Hospital, Tokai University School of Medicine, 1838 Ishikawa-machi, Hachioji, Tokyo, Japan.
Br J Radiol. 2021 Apr 1;94(1120):20200754. doi: 10.1259/bjr.20200754. Epub 2021 Feb 5.
We investigated the efficacy and exposure to radiation in 320-detector row computed tomography fluoroscopy-guided (CTF-guided) interventions.
We analysed 231 320-detector row CTF-guided interventions (207 patients over 2 years and 6 months) in terms of technical success rates, clinical success rates, complications, scanner settings, overall radiation doses (dose-length product, mGy*cm), patient doses of peri-interventional CT series, and interventional CT (including CTF), as a retrospective cohort study. The relationships between patient radiation dose and interventional factors were assessed using multivariate analysis.
Overall technical success rate was 98.7% (228/231). The technical success rates of biopsies, drainages, and aspirations were 98.7% (154/156), 98.5% (66/67), and 100% (8/8), respectively. The clinical success rate of biopsies was 93.5% (146/156). All three major complications occurred in chest biopsies. The median total radiation dose was 522.4 (393.4-819.8) mGy*cm. Of the total radiation dose, 87% was applied during the pre- and post-interventional CT series. Post-interventional CT accounted for 24.4% of the total radiation dose. Only 11.4% of the dose was applied by CTF-guided intervention. Multilinear regression demonstrated that male sex, body mass index, drainage, intervention time, and helical scan as post-interventional CT were significantly associated with higher dose.
The 320-detector row CTF interventions achieved a high success rate. Dose reduction in post-interventional CT provides patient dose reduction without decreasing the technical success rates.
This is the first study on the relationship between various interventional outcomes and patient exposure to radiation in 320-detector row CTF-guided interventions, suggesting a new perspective on dose reduction.
我们研究了 320 排螺旋 CT 透视引导(CTF 引导)介入的疗效和辐射暴露。
我们对 231 例 320 排 CTF 引导介入(207 例患者,2 年零 6 个月)进行了技术成功率、临床成功率、并发症、扫描仪设置、总辐射剂量(剂量长度乘积,mGy*cm)、介入 CT 系列和介入 CT(包括 CTF)的患者剂量分析,作为回顾性队列研究。使用多元分析评估患者辐射剂量与介入因素之间的关系。
总技术成功率为 98.7%(228/231)。活检、引流和抽吸的技术成功率分别为 98.7%(154/156)、98.5%(66/67)和 100%(8/8)。活检的临床成功率为 93.5%(146/156)。所有三种主要并发症均发生在胸部活检中。中位总辐射剂量为 522.4(393.4-819.8)mGy*cm。总辐射剂量的 87%应用于介入前和介入后 CT 系列。介入后 CT 占总辐射剂量的 24.4%。只有 11.4%的剂量由 CTF 引导的介入应用。多元线性回归显示,男性、体重指数、引流、介入时间和螺旋扫描作为介入后 CT 与更高的剂量显著相关。
320 排 CTF 介入成功率高。减少介入后 CT 剂量可在不降低技术成功率的情况下降低患者剂量。
这是第一项关于 320 排 CTF 引导介入中各种介入结果与患者辐射暴露之间关系的研究,为剂量减少提供了新的视角。