Advanced Intraprocedural Imaging Applications in Hepatobiliary Intervention

Patient Radiation Dose Reduction Considerations in a Contemporary Interventional Radiology Suite

PURPOSE

We sought to evaluate patient radiation exposure during complex liver interventional procedures performed with newer angiography equipment.

MATERIALS AND METHODS

We conducted a retrospective study of transjugular intrahepatic portosystemic shunt (TIPS) creations and liver tumor embolizations performed in our new angiography suite (Discovery IGS740, GE Healthcare). T tests were used to compare air kerma-area product (P_KA) and reference plane air kerma (K_a,r) in the new room versus data from historical rooms and previous studies (including the RAD IR study). Results were expressed as medians [interquartile ranges (Q1, Q3)].

RESULTS

From February 2015 to June 2016, 134 complex liver interventional procedures were performed in the new room, including 14 TIPS creations, 60 hepatic tumor arterial embolizations (HAEs), 26 Y90 mappings (Y90m), and 34 Y90 radioembolizations (Y90). K_a,r (Gy) values were as follows: TIPS, 0.65 (0.24, 1.15); HAE, 0.89 (0.49, 1.49); Y90m, 0.54 (0.38, 0.94); Y90, 0.46 (0.21, 1.06). P_KA (Gy·cm²) values were as follows: TIPS, 148.2 (66.7, 326.5); HAE, 142.6 (88, 217.8); Y90m, 148.3 (98.2, 247); Y90, 90.8 (43.9, 161.5). K_a,r and P_KA were lower in the new room than in historical rooms [K_a,r and P_KA reductions: TIPS, 58 and 49%; HAE, 31 and 39%; Y90m, 58 and 52%; Y90, 49 and 56% (p < 0.05)] and versus the RAD IR study [K_a,r and P_KA reductions: TIPS, 64 and 43%; HAE, 26 and 40% (p < 0.05)].

CONCLUSIONS

Using the latest technology and image processing tools enables significant reduction in radiation exposure during complex liver interventional procedures.