Department for Diagnostic and Interventional Radiology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
Center for Clinical Studies, University Hospital Jena, Jena, Germany.
Cardiovasc Intervent Radiol. 2021 Jul;44(7):1089-1094. doi: 10.1007/s00270-021-02787-4. Epub 2021 Mar 3.
To evaluate the effect of cone-beam computed tomography (CBCT) on radiation exposure, procedure time, and contrast media (CM) use in prostatic artery embolization (PAE).
Seventy-eight patients were enrolled in this retrospective, single-center study. All patients received PAE without (group A; n = 39) or with (group B; n = 39) CBCT. Total dose-area product (DAP; Gycm), total entrance skin dose (ESD; mGy), and total effective dose (ED; mSv) were primary outcomes. Number of digital subtraction angiography (DSA) series, CM use, fluoroscopy time, and procedure time were secondary outcomes. PAE in group A was performed by a single radiologist with 15 years experience, PAE in group B was conducted by four radiologists with 4 to 6 years experience.
For groups A vs. B, respectively, median (IQR): DAP 236.94 (186.7) vs. 281.20 (214.47) Gycm(p = 0.345); ED 25.82 (20.35) vs. 39.84 (23.75) mSv (p = < 0.001); ESD 2833 (2278) vs. 2563 (3040) mGy(p = 0.818); number of DSA series 25 (15) vs. 23 (10)(p = 0.164); CM use 65 (30) vs. 114 (40) mL(p = < 0.001); fluoroscopy time 23 (20) vs. 28 (25) min(p = 0.265), and procedure time 70 (40) vs.120 (40) min(p = < 0.001). Bilateral PAE was achieved in 33/39 (84.6%) group A and 32/39 (82.05%) group B(p = 0.761), all other patients received unilateral PAE. There were no significant differences between clinical parameters and origins of the prostatic arteries (PA) (p = 0.206-1.00).
Operators with extensive expertise on PAE may not benefit from addition of CBCT to DSA runs, whereas for operators with less expertise, CBCT when used alongside with DSA runs increased the overall radiation exposure.
评估锥形束 CT（CBCT）在前列腺动脉栓塞术（PAE）中对辐射暴露、手术时间和对比剂（CM）使用的影响。
本回顾性单中心研究共纳入 78 例患者。所有患者均接受了无（A 组，n=39）或有（B 组，n=39）CBCT 的 PAE。总剂量面积乘积（DAP；Gycm）、总入射皮肤剂量（ESD；mGy）和总有效剂量（ED；mSv）为主要结局。数字减影血管造影（DSA）系列数量、CM 使用、透视时间和手术时间为次要结局。A 组的 PAE 由一位具有 15 年经验的放射科医生进行，B 组的 PAE 由 4 至 6 名具有 4 至 6 年经验的放射科医生进行。
A 组与 B 组的中位数（IQR）分别为：DAP 236.94（186.7）比 281.20（214.47）Gycm（p=0.345）；ED 25.82（20.35）比 39.84（23.75）mSv（p<0.001）；ESD 2833（2278）比 2563（3040）mGy（p=0.818）；DSA 系列数量 25（15）比 23（10）（p=0.164）；CM 使用 65（30）比 114（40）mL（p<0.001）；透视时间 23（20）比 28（25）min（p=0.265），手术时间 70（40）比 120（40）min（p<0.001）。A 组中 33/39 例（84.6%）和 B 组中 32/39 例（82.05%）实现了双侧 PAE（p=0.761），其余所有患者均接受了单侧 PAE。PA 的临床参数和起源之间无显著差异（p=0.206-1.00）。
对于 PAE 经验丰富的操作者，在 DSA 运行中添加 CBCT 可能不会带来获益，而对于经验较少的操作者，CBCT 联合 DSA 运行会增加整体辐射暴露。
