Radiation Exposure During Transarterial Chemoembolization: Angio-CT Versus Cone-Beam CT

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Piron, Lauranne | Le Roy, Julien | Cassinotto, Christophe | Delicque, Julien | Belgour, Ali | Allimant, Carole | Beregi, Jean-Paul | Greffier, Joël | Molinari, Nicolas | Guiu, Boris

Edité par CCSD ; Cardiovascular and Interventional Radiological Society of Europe (CIRSE). -

International audience. Introduction: Cone-beam computed tomography (CBCT) has been developed to improve reliability of many interventional radiology (IR) procedures performed with Angio system, such as transarterial chemoembolization (TACE). Angio-CT has emerged as a new imaging technology that combines a CT scanner with an Angio system in the same IR suite. The purpose of our study was to compare Angio system with CBCT capability and Angio-CT in terms of patient radiation exposure during TACE procedures.Materials and methods: Consecutive TACE procedures performed between January 2016 and September 2017 with the two imaging modalities (Artis Zeego defining the CBCT group and Infinix-i 4D-CT defining the Angio-CT group) were reviewed. TACE and patient's characteristics and patient radiation exposure parameters were collected. Dose-area products (DAP) and dose-length products (DLP) were converted into effective doses (ED) using conversion factors. Accuracy of tumor targeting and response was retrospectively assessed.Results: A total of 114 TACE procedures in 96 patients were included with 57 procedures in each group. The total ED in the Angio-CT group was 2.5 times lower than that in the CBCT group (median 15.4 vs. 39.2 mSv, p < 0.001). Both 2D ED and 3D ED were lower in the Angio-CT group than in the CBCT group (5.1 vs. 20 mSv, p < 0.001, and 7.4 vs. 17.9 mSv, p < 0.001, respectively). There was no significant difference neither in terms of classes of tumor targeting (p = 0.509) nor in terms of classes of tumor response (p = 0.070) between both groups.Conclusion: Angio-CT provides significant decrease in patient effective dose during TACE procedures compared to Angio system with CBCT.

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