Liver Tumor Ablation Procedure Duration and Estimated Patient Radiation Dose: Comparing Positron Emission Tomography/CT and CT Guidance

Emmy Y Hu; Vincent M Levesque; Camden P Bay; Julia G Seol; Paul B Shyn

doi:10.1016/j.jvir.2019.11.036

Liver Tumor Ablation Procedure Duration and Estimated Patient Radiation Dose: Comparing Positron Emission Tomography/CT and CT Guidance

J Vasc Interv Radiol. 2020 Jul;31(7):1052-1059. doi: 10.1016/j.jvir.2019.11.036. Epub 2020 Jun 10.

Authors

Emmy Y Hu¹, Vincent M Levesque¹, Camden P Bay¹, Julia G Seol¹, Paul B Shyn²

Affiliations

¹ Department of Radiology, Division of Abdominal Imaging and Intervention, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115.
² Department of Radiology, Division of Abdominal Imaging and Intervention, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115. Electronic address: [email protected].

PMID: 32534979
DOI: 10.1016/j.jvir.2019.11.036

Abstract

Purpose: To compare procedure duration and patient radiation dose in positron emission tomography/computed tomography (PET/CT) and CT-guided liver tumor ablation procedures.

Materials and methods: In this retrospective, case-control study, 275 patients underwent 368 image-guided ablation procedures to treat 537 tumors. Radiologists used PET/CT guidance for 117 procedures and CT guidance for 251 procedures. PET/CT-guided procedures were performed by one radiologist (C: P.B.S.). All 3 radiologists (A: J.G.S., B: a radiologist who is not an author on this article, and C: P.B.S.) performed CT-guided procedures. Potential confounders included patient demographics, clinical and tumor characteristics, and procedural variables.

Results: The mean duration and estimated patient radiation dose of PET/CT-guided procedures performed by radiologist C were 21.5 ± 4.9 minutes longer and 0.7 ± 2.8 mSv higher than CT-guided procedures performed by all radiologists in an unadjusted comparison. Adjusting for confounding, mean duration and estimated dose of PET/CT-guided procedures performed by radiologist C were 28.3 ± 3.8 minutes longer (P < .0001) and 6.2 ± 2.9 mSv higher (P = .03) than CT-guided procedures performed by the same radiologist. Comparing CT-guided procedures performed by all 3 radiologists, adjusted mean durations and estimated patient doses of procedures by the least experienced radiologist, radiologist A, and the second most experienced radiologist, radiologist B, were 24.2 ± 5.1 (P < .0001) and 18.1 ± 8.9 (P = .04) minutes longer and 13.1 ± 3.7 (P < .001) and 14.5 ± 6.4 (P = .02) mSv higher, respectively, than procedures performed by the most experienced radiologist, radiologist C.

Conclusions: PET/CT-guided liver ablations had a slightly longer duration with slightly higher estimated patient radiation dose than similar CT-guided liver ablations. Procedure duration and patient dose do not appear to be major impediments to the emerging field of PET/CT-guided tumor ablation.

Publication types

Comparative Study

MeSH terms

Ablation Techniques* / adverse effects
Adult
Aged
Aged, 80 and over
Cryosurgery* / adverse effects
Female
Humans
Liver Neoplasms / diagnostic imaging
Liver Neoplasms / surgery*
Male
Microwaves / adverse effects
Microwaves / therapeutic use*
Middle Aged
Operative Time
Positron Emission Tomography Computed Tomography* / adverse effects
Radiation Dosage*
Radiation Exposure* / adverse effects
Radiography, Interventional* / adverse effects
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Tomography, X-Ray Computed* / adverse effects
Treatment Outcome