Yuan Hui, Li Da, Zhang Yan, Xie Xiaozhen, Shen Lujun
Sun Yat-sen University Cancer Center, China.
State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University, Guangzhou 510060, People's Republic of China.
J Interv Med. 2021 May 21;4(3):143-148. doi: 10.1016/j.jimed.2021.05.005. eCollection 2021 Aug.
To investigate the value of application of low-dose and optimized length CT scan on puncture results, complications and patients' radiation dosage during CT-guided percutaneous biopsy of pulmonary nodules (PTNB).
A total of 231 patients with PTNB under CT guidance were collected. Low dose scanning utilized tube current of 20 mA as compared with 40 mA in conventional dosage. Optimized length in CT is defined as intentionally narrowing the range of CT scanning just to cover 25 mm (5 layers) around the target layer during needle adjustment. According to whether low-dose scans and optimized length scans techniques were utilized, patients were divided into three groups: conventional group (conventional sequence + no optimization), optimized length group (conventional sequence + optimized length), and low-dose optimized length group (low dose sequence + optimized length). The ED (effective dose), the DLP (dose length product), the average CTDIvol (Volume CT dose index), total milliampere second between subgroups were compared.
Compared with the conventional group, ED, intraoperative guidance DLP, total milliseconds and operation time in the optimized length group were reduced by 18.2% (P=0.01), 37% (P=0.003), 17.5% (P=0.013) and 13.3% (P=0.021) respectively. Compared with the optimized length group, the ED was reduced by 87%, preoperative positioning, intraoperative guidance and postoperative review DLP were also reduced by 88%, total milliampere second was reduced by 79%, with an average CTDIvol was reduced by 86%, in the low-dose optimized length group (P<0.001 for all).
Optimizing the length during CT scanning can effectively reduce the intraoperative radiation dose and reduce the operation time compared with conventional plan; low-dose and optimized length CT scan can further reduce the total radiation dose compared with optimized length group with no differences on intraoperative complications, biopsy results and operation time.
探讨低剂量及优化扫描长度CT扫描在CT引导下肺结节经皮穿刺活检（PTNB）中对穿刺结果、并发症及患者辐射剂量的应用价值。
收集231例CT引导下PTNB患者。低剂量扫描采用20 mA管电流，传统剂量为40 mA。CT优化扫描长度定义为在进针调整过程中，有意缩小CT扫描范围，仅覆盖目标层面周围25 mm（5层）。根据是否采用低剂量扫描及优化扫描长度技术，将患者分为三组：传统组（传统序列+未优化）、优化长度组（传统序列+优化长度）和低剂量优化长度组（低剂量序列+优化长度）。比较亚组间的有效剂量（ED）、剂量长度乘积（DLP）、平均容积CT剂量指数（CTDIvol）、总毫安秒。
与传统组相比，优化长度组的ED、术中引导DLP、总毫秒数及手术时间分别降低了18.2%（P = 0.01）、37%（P = 0.003）、17.5%（P = 0.013）和13.3%（P = 0.021）。与优化长度组相比，低剂量优化长度组的ED降低了87%，术前定位、术中引导及术后复查DLP也降低了88%，总毫安秒降低了79%，平均CTDIvol降低了86%（所有P < 0.001）。
与传统方案相比，CT扫描时优化扫描长度可有效降低术中辐射剂量并缩短手术时间；低剂量及优化扫描长度CT扫描与优化长度组相比可进一步降低总辐射剂量，且术中并发症、活检结果及手术时间无差异。
