scholarly journals Impact factors for safety, success, duration and radiation exposure in CT-guided interventions

2019 ◽  
Vol 92 (1099) ◽  
pp. 20180937 ◽  
Author(s):  
Maurice Pradella ◽  
Christoph Trumm ◽  
Bram Stieltjes ◽  
Daniel T Boll ◽  
Christoph J Zech ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Radiation Dose ◽  
Success Rate ◽  
Clinical Success ◽  
Full Time ◽  
Ct Guided ◽  
Procedure Duration ◽  
The Impact ◽  
Teaching Setting ◽  
Radiology Staff

Objective: We aim to compare factors influencing safety, success rate and radiation dose of CT-guided biopsies and drainages in a non-teaching setting with experienced operators vs a teaching setting with residents. Methods: A total of 1021 cases were retrospectively analyzed regarding lesion size, distance from skin, procedure duration, radiation dose, complications and clinical success. Procedures were grouped into biopsies of lung, liver, (remaining) abdomen, musculoskeletal system (MSK) and drainages of any region. Procedures in non-teaching setting were performed by experienced operators (full time interventional radiology staff), teaching setting consisted of residents under supervision of interventional radiology staff. Results: Overall clinical success rate was 93.6 % [experienced (exp.) vs teaching setting: 93.5 and 93.6 %, p = 0.97]. Overall complication rate was 7.2% (5.7% minor, 1.6% major; exp. vs teaching: 8.0 and 6.5 %, p = 0.67]. Experienced operators performed chest and liver biopsies faster even though they were facing smaller lesions. Multiple regression analysis revealed that depth from skin significantly increased procedure duration by 36.8 s per cm (p < 0.001) and also radiation dose by 5.4 mGy per cm (p < 0.001) in all interventions. On average, teaching setting increased the duration of an intervention by 209.8 s and total radiation dose by 10.6 mGy (p < 0.001, p < 0.001 respectively). Conclusion: CT guided interventions can be performed safe und successful disregarding anatomical parameters or teaching setting. Depth from skin and teaching setting should be taken into account both from a clinical and a time-conscious point of view since they increase radiation dose and prolong operations. Advances in knowledge: This is the first study with >1000 interventions which shows and quantifies the impact of lesion depth and teaching setting in CT-guided interventions.

scholarly journals Reduction of patient radiation dose during percutaneous CT vertebroplasty: Impact of a new computer-assisted navigation (CAN) system

2020 ◽  
Vol 55 (1) ◽  
pp. 11-16
Author(s):  
C. Teriitehau ◽  
H. Rabeh ◽  
E. Pessis ◽  
Q. Sénéchal ◽  
F. Besse ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Percutaneous Vertebroplasty ◽  
Control Group ◽  
Computer Assisted ◽  
Ct Guided ◽  
Assisted Navigation ◽  
Procedure Duration ◽  
Conventional Ct ◽  
The Impact ◽  
Patient Radiation Dose

To assess the impact of a computer assisted navigation system (CAN) (CT-Navigation™ IMACTIS, France) on patient radiation doses during percutaneous CT vertebroplasty a retrospective comparative trial was performed and included 37 patients requiring percutaneous vertebroplasty. This study was approved by CCN (Centre Cardiologique du Nord, Saint-Denis, France) ethical committee; all patients provided informed consent. All procedures were conducted in the interventional radiology department at CCN, by an experienced single radiologist using the same model and CT scan with identical parameters. The interventional dose length product (IDLP), representing the absorbed dose by the length of explored organs during the needle insertion phase, was compared in 15 consecutive patients who underwent a conventional procedure (CT control group), and in 22 patients who underwent CAN CT vertebroplasty (CAN group). The IDLP difference between the two groups was evaluated using Mann–Whitney U test. The median IDLP dose for the CAN group was 305.6 mGy.cm [182.3; 565.4], representing a reduction by a 3.2 factor compared with that of the conventional CT group (median 975.2 mGy.cm [568.3; 1077.1]; p < 0.001). The median procedure duration for the CAN group was 50 min [35; 60] vs. 100 min [82; 100] in the CT group (p < 0.001), representing a 50% reduction. In experienced hands, use of a CT-Navigation™ system (IMACTIS®) significantly reduced both patient radiation dose and procedure duration when compared to conventional CT guided percutaneous vertebroplasty.

Effect of Real-Time Radiation Dose Feedback on Pediatric Interventional Radiology Staff Radiation Exposure

2014 ◽  
Vol 25 (1) ◽  
pp. 119-126 ◽  
Author(s):  
John Racadio ◽  
Rami Nachabe ◽  
Bart Carelsen ◽  
Judy Racadio ◽  
Nicole Hilvert ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Radiation Dose ◽  
Radiation Exposure ◽  
Real Time ◽  
Radiology Staff

scholarly journals A Prospective Comparison of Bone Marrow Biopsy Adequacy with and without Use of Powered Assistive Drill in the Clinical Setting Versus Interventional Radiology

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4823-4823
Author(s):  
Tara T. Barnett ◽  
Jana M. Reynolds ◽  
Andrew Shakespeare ◽  
Paul Dye ◽  
Edward S. Rappaport ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Interventional Radiology ◽  
Bone Marrow Biopsy ◽  
Clinical Setting ◽  
Tertiary Care ◽  
Bone Marrow Biopsies ◽  
Ct Guided ◽  
Clinical Site ◽  
The Mean ◽  
The Impact

Abstract Background The adequacy of bone marrow biopsies is most often defined by trephine length. By this definition, adequacy has been associated with the experience of the procedure operator. In small prospective studies, powered assistive drills have also affected adequacy as their use has been shown to yield longer trephine lengths as compared to manual devices. Within our Central Texas academic institution tertiary care center, we have noted the two following recent changes in our bone marrow biopsy practice: routine implementation of the powered assistive drill and the use of interventional radiology for CT-guided bone marrow biopsies of more difficult patients (i.e. obese body habitus, altered anatomy, previous failed attempts, etc.), and those who desire sedation. This study aims to review the impact of powered assistive drill use and referral to interventional radiology on the adequacy of bone marrow biopsies at our institution. Methods Consecutive bone marrow biopsies performed at the Baylor Scott & White Health clinical site 1 (CS1), one of the satellite clinics (CS2), and interventional radiology (IR) from January 1, 2011, through December 31, 2013, were eligible for inclusion. Patients less than 18 years of age were excluded. A prospective registry recorded the date of procedure, patient medical record number, patient age, as well as the presence of spicules within the aspirate (yes or no), and trephine length (in mm) determined by pathology. Procedure location and use of the powered assistive drill for each procedure were determined by billing codes. Trephine length was compared between locations and by use of the assistive drill with Wilcoxon two-sample tests. Results In total, 888 bone marrow biopsies were performed. 753 were performed in the clinical setting (554 at CS1 and 199 at CS2), and 135 in IR. Overall, 326 biopsies utilized the powered drill and 562 were performed manually. Mean trephine length, independent of assistive drill use, was 10.1 mm, 10.3 mm, and 7.4 mm at CS1, CS2, and IR locations respectively; with a significantly shorter trephine length observed in IR as compared to CS1 (p < 0.0001), and CS2 (p <0.0001). The mean trephine length of biopsies obtained with use of the assistive drill was significantly longer than those performed manually at CS1 (10.8 mm vs 9.3 mm [p = 0.0004]), and in IR (10.6mm vs 5.9 mm [p <0.0001]), respectively. There was no difference in mean trephine length between CS1 and IR with use of the drill (10.8 mm and 10.6 mm [p = 0.8123]). The presence of spicules did not differ with the use of the assistive drill at either location (p = 0.9463). CS2 has not yet implemented the routine use of the powered assistive drill. Discussion A statistically significant increase in mean trephine length was observed with use of the assistive drill between CS1 and IR, though the only difference of clinical significance was that observed in IR. With use of the drill, however, the mean trephine lengths between our clinical site and interventional radiology was no longer statistically significant. The use of the assistive drill in IR simply increased trephine length to equal those obtained routinely in the clinical setting. This suggests the use of powered assistive devices, in a patient population for whom CT-guidance is necessary, may increase the likelihood of obtaining a trephine of similar adequacy to those performed on the “ideal” patient at the bedside by experienced operators. Disclosures No relevant conflicts of interest to declare.

First experiences of a low-dose protocol for CT-guided musculoskeletal biopsies combining different radiation dose reduction techniques

2019 ◽  
Vol 61 (1) ◽  
pp. 28-36
Author(s):  
Zlatan Alagic ◽  
Haris Alagic ◽  
Robert Bujila ◽  
Subhash Srivastava ◽  
Saif Jasim ◽  
...  
Keyword(s):  
Image Quality ◽  
Radiation Dose ◽  
Success Rate ◽  
Low Dose ◽  
Quality Parameters ◽  
Ct Guided ◽  
Protocol Group ◽  
Group A ◽  
The Mean ◽  
Group B

Background The use of computed tomography (CT) for image guidance during biopsies is a powerful approach. The method is, however, often associated with a significant level of radiation exposure to the patient and operator. Purpose To investigate if a low-dose protocol for CT-guided musculoskeletal (MSK) biopsies, including a combination of different radiation dose (RD) techniques, is feasible in a clinical setting. Material and Methods Fifty-seven patients underwent CT-guided fine-needle aspiration cytology (FNAC) utilizing the low-dose protocol (group A). A similar number of patients underwent CT-guided FNAC using the reference protocol (group B). Between-group comparisons comprised radiation dose, success rate, image quality parameters, and workflow. Results In group A, the mean total dose-length product (DLP) was 41.2 ± 2.9 mGy*cm, which was statistically significantly lower than of group B (257.4 ± 22.0 mGy*cm), corresponding to a mean dose reduction of 84% ( P<0.001). The mean CTDIvol for the control scans were 1.88 ± 0.09 mGy and 13.16 ± 0.40 mGy for groups A and B, respectively ( P < 0.001). The success rate in group A was 91.2% and 87.9% in group B ( P = 0.56). No negative effect on image-quality parameters, time of FNAC, and number of control scans were found. Conclusion We successfully developed a low-dose protocol for CT-guided MSK biopsies that maintains diagnostic accuracy and image quality at a fraction of the RD compared to the reference biopsy protocol at our clinic.

scholarly journals Qualitative assessment of chronic pain management in patients undergoing computed tomography-guided procedures

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ralph Jeffrey ◽  
Roy Santosham ◽  
Gayathri Nagenthran ◽  
Bhawna Dev ◽  
Rupesh Mandava ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Success Rate ◽  
Clinical Success ◽  
Stellate Ganglion ◽  
Clinical Success Rate ◽  
Qualitative Assessment ◽  
Ct Guidance ◽  
Ct Guided ◽  
Management Procedure

Abstract Background To study the qualitative efficacy and safety of percutaneous pain management under CT guidance. The success rate of medical management for chronic pain in long term is very less. This study aids in evaluating the clinical success rate in each CT-guided pain management procedure we have done. Results Among the 60 patients, 39 (65%) were male patients and 21 (35%) were female patients. We did 40 celiac plexus neurolysis (66.7%), 13 radiofrequency ablations (21.6%), 4 stellate ganglion neurolysis (6.7%), and 3 trigeminal nerve neurolysis (5%). The average pre-procedural pain score in all the procedures was 7 which was significantly reduced to 1 in 24 h and 1 and 3 months. Conclusion Percutaneous pain management under CT guidance by virtue of its precise needle placement offers effective pain relief. It has a lower rate of complications, reduces the need for repeat procedures, and ultimately increases the quality of life.

First experience of efficacy and radiation exposure in 320-detector row CT fluoroscopy-guided interventions

2021 ◽  
pp. 20200754
Author(s):  
Shota Yamamoto ◽  
Tomohiro Matsumoto ◽  
Satoshi Suda ◽  
Kosuke Tomita ◽  
Shunsuke Kamei ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Success Rate ◽  
Dose Reduction ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Total Radiation ◽  
Success Rates ◽  
Technical Success ◽  
Total Radiation Dose ◽  
Interventional Ct

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.

scholarly journals Percutaneous afferent lymphatic vessel sclerotherapy for postoperative lymphatic leakage after previous ineffective therapeutic transpedal lymphangiography

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
F. Pan ◽  
M. Loos ◽  
T. D. Do ◽  
G. M. Richter ◽  
H. U. Kauczor ◽  
...  
Keyword(s):  
Success Rate ◽  
Lymphatic Vessel ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Technical Success ◽  
Ct Guided ◽  
Technical Success Rate ◽  
Lymphatic Fistula ◽  
Leakage Site

Abstract Background To demonstrate the efficacy of percutaneous computed tomography (CT)-guided afferent lymphatic vessel sclerotherapy (ALVS) in the treatment of postoperative lymphatic leakage (LL) after ineffective therapeutic transpedal lymphangiography (TL). Methods A retrospective review in this institute involving 201 patients was conducted from May 2011 to September 2018. Patients diagnosed with postoperative LL undergoing ineffective therapeutical TL before the performance of percutaneous CT-guided ALVS were involved. Technical success and clinical success of TL and ALVS were established. The technical success and efficacy of ALVS in the treatment of postoperative LL after ineffective therapeutic TL were assessed. The clinical success rate of ALVS is also assessed, and the complications are reviewed. Results In total, nine patients were involved including three patients (33.3%) presented with chylothorax, three patients (33.3%) presented with inguinal lymphatic fistula/lymphocele, and three patients (33.3%) presented with lymphatic fistula in the thigh; 27 ± 18 days (mean ± standard deviation) after surgery, therapeutic TL was successfully performed and showed definite afferent lymphatic vessel and leakage site in all the patients. Due to clinical failure after TLs, the following ALVS was performed with a mean interval of 12 ± 8 days after TL. The technical success rate was 9/9 (100.0%, 95% confidence interval [CI] 63.1–100.0%). An average of 2.7 ± 1.3 mL 95% ethanol as sclerosant agent was injected during the procedure. The clinical success was observed in 8 of the 9 patients (88.9%, 95% CI 51.8–99.7%) with a time between ALVS and the LL cure of 8 ± 6 days. No complications were reported. Conclusions Our results showed the role of percutaneous CT-guided ALVS as a safe, feasible, and effective salvage treatment for postoperative LL after ineffective TL.

scholarly journals Role of percutaneous computed tomography-guided radiofrequency ablation in treatment of osteoid osteoma

2017 ◽  
Vol 06 (04) ◽  
pp. 139-140 ◽  
Author(s):  
Ajay R. Upadhyay ◽  
Nikunj Chandrakant Desai ◽  
Digish U. Vaghela
Keyword(s):  
Computed Tomography ◽  
Radiofrequency Ablation ◽  
Success Rate ◽  
Osteoid Osteoma ◽  
Clinical Success ◽  
Tertiary Care ◽  
Ct Guidance ◽  
Western India ◽  
Ct Guided

Abstract Aim: The aim of the study was to evaluate efficacy of percutaneous computed tomography (CT)-guided radiofrequency ablation (RFA) of nidus in osteoid osteoma (OO). Materials and Methods: RFA was performed on fifty patients with clinically and radiologically diagnosed OO. RFA was done in the department of radio-diagnosis in our institute (a tertiary care providing institute in Ahmedabad, Western India). Ablation was performed by putting at an electrode tip (3–5 mm) into nidus under CT guidance with targeted temperature of 90°C for 3 min. Results: All procedures were technically successful. No immediate major or minor complications were observed. Complete clinical success was achieved in 46 patients. Only four patients required second intervention. Conclusion: Our experience indicates a 98% success rate. No major complications were noted.

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