- Design
- Single-centre retrospective dose comparison
- Population
- 92 intra-arterial liver procedures: 48 cone-beam CT, 44 angio-CT
- Primary outcome
- Effective radiation dose (2D, 3D and total)
- Effect
- 3D dose 9.85 vs 39.9 mSv (P < 0.001); total 34.6 vs 55.9 mSv (corrected P = 0.053)
This single-centre retrospective study compared patient dose in 92 intra-arterial liver procedures (bland embolisation and radioembolisation mapping) on a hybrid angiography suite: 48 with single-phase cone-beam CT and 44 with dual-phase angio-CT. Effective doses were estimated from dose-area and dose-length products.
Fluoroscopy dose was comparable. The 3D dose was 4.1-fold lower with angio-CT (median 9.85 mSv against 39.9 mSv; P < 0.001), and the total dose 1.6-fold lower (34.6 mSv against 55.9 mSv). After correcting for dose conversion uncertainty, the 3D difference remained significant, but the total dose difference did not (P = 0.053).
The fair reading is that angio-CT did not raise patient dose, and probably lowered the dose from the 3D acquisition. That fits a decision to use angio-CT for its image quality where it is available, but the study does not show a total dose saving. Procedure choice rests on diagnostic needs.
- Angio-CT did not add dose compared with cone-beam CT in this series.
- Do not quote a total dose reduction; it was not significant after uncertainty correction.
- Review local protocols, since 3D dose depends on acquisition settings.
- Record both dose-area and dose-length product for each procedure.
Why it matters
A fear of extra radiation need not block adoption of a better imaging modality in the angiography suite.
Don't overread it
A retrospective two-group comparison at one centre cannot establish a dose saving, and groups may have differed in other ways.
The statistics, in plain English
Effective dose is estimated, not measured, and the conversion factors carry error. Once that error was built into the analysis, the total dose difference had a P value of 0.053, so it could be chance.
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