Radiation Dose and Risk Estimates of CT-Guided Percutaneous Liver Ablations and Factors Associated with Dose Reduction.

Abstract:

PURPOSE:To determine the radiation dose associated with CT-guided percutaneous liver ablations and identify potential risk factors that result in higher radiation doses. MATERIALS AND METHODS:Between June 2011 and June 2015, 245 consecutive patients underwent 304 CT-guided liver ablation treatments. Patient demographics, tumor characteristics and procedural parameters were identified and analyzed. The peak skin dose and effective dose were assessed for each procedure. Excess relative risk related to radiation effects was calculated. A logistic regression model was prepared by means of stepwise logistic regression to identify variables predictive of increased radiation exposure. RESULTS:Tumor ablations were performed with microwave (n = 220), radiofrequency (n = 74) or irreversible electroporation (IRE) (n = 10). The mean peak skin dose for ablations was 239.2 ± 136.4 mGy, and the mean effective dose was 36.6 ± 22.3 mSv. Of the patient and procedural parameters that were analyzed, increasing weight, use of intravenous contrast and/or hydrodissection during the procedure, together with treatment of multiple lesions in the same sitting were all associated with higher radiation exposure. The mean increase in the absolute risk of fatal malignancy from a single procedure was 0.18% (range 0.02-0.9%). No deterministic skin changes were identified in the patient cohort. CONCLUSION:The overall risk of stochastic and deterministic effects from radiation associated with CT-guided ablations is low compared with other inherent procedural complications. This study identifies several factors that are associated with higher radiation dose in percutaneous liver ablation procedures.

authors

McCarthy CJ,Kilcoyne A,Li X,Cahalane AM,Liu B,Arellano RS,Uppot RN,Gee MS

doi

10.1007/s00270-018-2066-1

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

1935-1942

issue

12

eissn

0174-1551

issn

1432-086X

pii

10.1007/s00270-018-2066-1

journal_volume

41

pub_type

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