Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin 4, Ireland.
Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Radiat Prot Dosimetry. 2022 Jul 1;198(8):441-447. doi: 10.1093/rpd/ncac077.
This study investigated the effects of cone-beam computed tomography (CBCT) guidance in trans-arterial chemoembolisation (TACE) procedures on the number of digital subtraction angiography (DSA) runs acquired and total patient radiation exposure in patients with hepatocellular carcinoma (HCC). A retrospective, analytical cross-sectional, single institution, study was conducted. Dose data were compared across the control (DSA guidance alone) and study (DSA and CBCT guidance) groups. A total of 122 procedures were included within the study. There was a significant reduction in the number of DSA runs (3 vs 5, p < 0.001) and DSA air kerma-area product (PKA) (3077.3 vs 4276.6 μGym2, p = 0.042) for the study group when compared to the control group. Total procedural PKA and total procedural reference air kerma (Ka,r) were shown to be 50 and 73% higher, respectively, for the study group when compared to the control group. CBCT imaging guidance does reduce the number of DSA runs and DSA PKA required to complete the TACE procedure for patients diagnosed with HCC; however, a substantial increase in total procedural PKA is to be expected and it is thus important that this increased dose is carefully considered and justified.
本研究旨在探讨锥形束 CT（CBCT）引导在经动脉化疗栓塞（TACE）手术中对肝癌（HCC）患者数字减影血管造影（DSA）次数和总患者辐射暴露量的影响。采用回顾性、分析性、单中心、研究设计。比较了对照组（仅 DSA 引导）和研究组（DSA 和 CBCT 引导）的剂量数据。该研究共纳入 122 例患者。与对照组相比，研究组的 DSA 运行次数（3 次与 5 次，p<0.001）和 DSA 空气比释动能面积乘积（PKA）（3077.3 与 4276.6 μGym2，p=0.042）显著减少。与对照组相比，研究组的总程序 PKA 和总程序参考空气比释动能（Ka,r）分别高出 50%和 73%。CBCT 成像引导确实可以减少 HCC 患者 TACE 手术所需的 DSA 运行次数和 DSA PKA；然而，预计总程序 PKA 将大幅增加，因此需要仔细考虑和证明增加的剂量是合理的。
