Sajan Abin, Griepp Daniel W, Isaacson Ari J
Department of Radiology, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY 10032, USA.
Department of Neurosurgery, Henry Ford Providence Michigan State University, East Lansing, MI 48824, USA.
J Clin Med. 2024 Dec 5;13(23):7403. doi: 10.3390/jcm13237403.
: We aimed to compare cone beam computed tomography (CBCT) utilization and radiation exposure during prostatic artery embolization (PAE) procedures on two different angiography systems. : PAEs performed by a single interventionalist between January 2018 and October 2020 on two multivendor angiography systems (AS1 and AS2) at a single center were retrospectively evaluated. Imaging techniques included CBCT acquisition when possible, predominantly from the distal aorta in AS1 and from the bilateral internal iliac arteries in AS2 (Discovery IGS 740, GE HealthCare, Chicago, IL). Baseline demographics, CBCT utilization and radiation doses, and total procedure radiation metrics for each group were collected and compared. : One hundred and twenty patients were analyzed in this study, with fifty-three patients ( = 25 in AS1, 28 in AS2) included as embolized bilaterally using CBCT. CBCT was acquired in 31% of the cases in AS1 and in 85% of the cases in AS2. Mean prostate volume was similar in both groups (103.0 mL vs. 130.1 mL, = 0.23). There was no difference in fluoroscopy time, while the number of DSA series and CBCTs per case did differ in AS1 and AS2 (37.3 min vs. 32.1 min, = 0.13, 19.8 vs. 8.0, ≤ 0.001, 1.3 vs. 2.1 ≤ 0.001). The mean total air kerma, total kerma area product and air kerma per CBCT were higher in AS1 compared to AS2 (2020.4 mGy vs. 490.3 mGy, ≤ 0.001, 259.3 Gycm vs. 72.7 Gycm, ≤ 0.001 and 217.8 mGy vs. 45.8 mGy, ≤ 0.001 respectively). To prevent confounding from a mean difference in body mass index, the data were adjusted using log outcome means, which corroborated the raw data findings. : The mean procedural total kerma area product from AS1 was similar to that reported in other PAE studies, but it was substantially lower in AS2. The angiography system used has a significant impact on the ability to leverage CBCT and on overall patient and thus staff radiation exposure.
我们旨在比较在两种不同血管造影系统上进行前列腺动脉栓塞术（PAE）时锥形束计算机断层扫描（CBCT）的使用情况和辐射暴露。回顾性评估了一名介入医生在2018年1月至2020年10月期间于单一中心的两种多厂商血管造影系统（AS1和AS2）上进行的PAE。成像技术包括尽可能进行CBCT采集，在AS1中主要从腹主动脉远端采集，在AS2中从双侧髂内动脉采集（Discovery IGS 740，通用电气医疗集团，伊利诺伊州芝加哥）。收集并比较了每组的基线人口统计学数据、CBCT使用情况和辐射剂量以及总手术辐射指标。本研究分析了120例患者，其中53例患者（AS1组25例，AS2组28例）使用CBCT进行双侧栓塞。AS1组31%的病例进行了CBCT采集，AS2组为85%。两组的平均前列腺体积相似（103.0 mL对130.1 mL，P = 0.23）。透视时间无差异，但AS1和AS2每组病例的数字减影血管造影（DSA）系列数量和CBCT数量存在差异（37.3分钟对32.1分钟，P = 0.13，19.8对8.0，P≤0.001，1.3对2.1，P≤0.001）。与AS2相比，AS1的平均总空气比释动能、总比释动能面积乘积和每次CBCT的空气比释动能更高（2020.4 mGy对490.3 mGy，P≤0.001，259.3 Gy·cm对72.7 Gy·cm，P≤0.001，217.8 mGy对45.8 mGy，P≤0.001）。为防止体重指数平均差异造成的混杂影响，使用对数结果均值对数据进行了调整，这证实了原始数据的结果。AS1的平均手术总比释动能面积乘积与其他PAE研究报告的相似，但在AS2中则低得多。所使用的血管造影系统对利用CBCT的能力以及患者和工作人员的总体辐射暴露有重大影响。
