First experience of efficacy and radiation exposure in 320-detector row CT fluoroscopy-guided interventions
First experience of efficacy and radiation exposure in 320-detector row CT fluoroscopy-guided interventions
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DOI：
10.1259/bjr.20200754
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发表时间：
2021-01-01
影响因子：
2.6
通讯作者：
Hasebe, Terumitsu
中科院分区：
文献类型：
--
作者：
Yamamoto, Shota;Matsumoto, Tomohiro;Hasebe, Terumitsu
目的：探讨320排CT透视引导介入治疗的疗效和辐射暴露情况。方法：采用回顾性队列研究的方法，对231例(207例)320排CT引导介入治疗的技术成功率、临床成功率、并发症、扫描仪设置、总辐射剂量(剂量长度乘积，mGY*cm)、介入治疗患者剂量和介入CT(包括CTF)进行回顾性队列研究。结果：总体技术成功率为98.7%(228/231)。活检成功率为98.7%(154/156)，引流成功率为98.5%(66/67)，活检成功率为100%(8/8)。临床活检成功率为93.5%(146/156)。所有三个主要并发症都发生在胸部活检中。中位总剂量为522.4(393.4~819.8)mGycm。在总辐射剂量中，87%是在介入前和介入后的CT序列中应用的。介入后CT占总剂量的24.4%。CTF引导介入治疗的剂量仅占总剂量的11.4%。多元线性回归分析显示，男性、体重指数、引流、介入时间、螺旋扫描为介入后CT的高剂量相关因素。结论：320排CTF介入治疗成功率高。介入后CT的剂量减少在不降低技术成功率的情况下减少了患者的剂量。知识进展：这是第一次在320排CTF引导的介入中研究不同介入结果与患者辐射暴露之间的关系，提出了减少剂量的新视角。
Objective: We investigated the efficacy and exposure to radiation in 320-detector row computed tomography fluoroscopy-guided (CTF-guided) interventions.Methods: We analysed 231 320-detector row CTF-guided interventions (207 patients over 2 years and 6 months) in terms of technical success rates, clinical success rates, complications, scanner settings, overall radiation doses (dose-length product, mGy*cm), patient doses of peri-interventional CT series, and interventional CT (including CTF), as a retrospective cohort study. The relationships between patient radiation dose and interventional factors were assessed using multivariate analysis.Results: Overall technical success rate was 98.7% (228/231). The technical success rates of biopsies, drainages, and aspirations were 98.7% (154/156), 98.5% (66/67), and 100% (8/8), respectively. The clinical success rate of biopsies was 93.5% (146/156). All three major complications occurred in chest biopsies. The median total radiation dose was 522.4 (393.4-819.8) mGy*cm. Of the total radiation dose, 87% was applied during the pre- and post-interventional CT series. Post-interventional CT accounted for 24.4% of the total radiation dose. Only 11.4% of the dose was applied by CTF-guided intervention. Multilinear regression demonstrated that male sex, body mass index, drainage, intervention time, and helical scan as post-interventional CT were significantly associated with higher dose.Conclusion: The 320-detector row CTF interventions achieved a high success rate. Dose reduction in post-interventional CT provides patient dose reduction without decreasing the technical success rates.Advances in knowledge: This is the first study on the relationship between various interventional outcomes and patient exposure to radiation in 320-detector row CTF-guided interventions, suggesting a new perspective on dose reduction.