- Design
- Retrospective single-centre comparison with bootstrap and permutation testing
- Population
- 92 intra-arterial liver procedures: 48 cone-beam CT, 44 angio-CT
- Primary outcome
- Effective radiation dose (fluoroscopy, 3D and total)
- Effect
- 3D dose median 9.85 vs 39.9 mSv; total 34.6 vs 55.9 mSv (corrected P = 0.053)
This retrospective study compared radiation dose in 92 bland embolisation and radioembolisation mapping procedures between 2021 and 2024: 44 done with dual-phase angio-CT and 48 with single-phase cone-beam CT on a hybrid angiography suite.
Fluoroscopy dose was comparable. The three-dimensional effective dose was about four times lower with angio-CT (median 9.85 mSv vs 39.9 mSv). Total effective dose was 34.6 mSv against 55.9 mSv. After the authors corrected for uncertainty in converting dose-area and dose-length products, the three-dimensional difference remained significant but the total dose difference did not (corrected P = 0.053).
The fair reading is that dual-phase angio-CT did not raise dose, which is its main message, not that it lowered it. Dose conversion factors carry real uncertainty, and the study was not randomised.
- Do not assume angio-CT increases dose compared with cone-beam CT for these procedures.
- Review your own dose-area and dose-length product records after changing technique.
- Treat the lower 3D dose as plausible, but the total dose difference as unproven.
- Weigh image quality benefits, which this study did not measure.
Why it matters
A better imaging option is easier to adopt if it does not cost the patient extra radiation.
Don't overread it
Retrospective, 92 procedures at one centre; the total dose difference did not hold after uncertainty correction.
The statistics, in plain English
Effective dose is calculated from machine readings using conversion factors, so it is an estimate. The authors repeated the comparison allowing for that uncertainty, and the total dose difference then fell just short of significance, so the safest statement is no evidence of higher dose.
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