- Design
- Single-centre retrospective comparison
- Population
- 92 intra-arterial liver procedures: 48 cone-beam CT, 44 dual-phase angio-CT
- Primary outcome
- Patient effective dose (2D, 3D and total)
- Effect
- 3D dose median 9.85 vs 39.9 mSv (p < 0.001); total 34.6 vs 55.9 mSv (corrected p = 0.053)
Hybrid angiography suites with an integrated CT scanner give better images than C-arm cone-beam CT during intra-arterial liver procedures, but there has been concern that they add radiation. A retrospective European Radiology study compared 92 bland embolisation and radioembolisation mapping procedures performed with single-phase cone-beam CT (48) or dual-phase angio-CT (44).
Fluoroscopy dose was similar. The 3D imaging dose was about four times lower with angio-CT (median 9.85 against 39.9 mSv, p < 0.001), and total effective dose was 34.6 against 55.9 mSv. After correcting for uncertainty in dose conversion, the 3D reduction remained significant but the total dose difference did not (p = 0.053).
For interventional radiologists choosing between the two, the conclusion is that angio-CT does not carry a dose penalty and may lower 3D dose, so image quality can drive the choice where both are available. This is a single-centre retrospective comparison with differing case mix.
- Where available, angio-CT can be used for intra-arterial liver procedures without concern for added patient dose.
- 3D imaging dose was about four times lower with dual-phase angio-CT than with single-phase cone-beam CT.
- Total procedural dose was not higher with angio-CT and may be lower.
- Record dose metrics for each procedure to support local optimisation.
Why it matters
A perceived radiation penalty has been one reason to hesitate over angio-CT; this study did not find one.
Don't overread it
The total dose reduction lost significance after uncertainty correction, so claim no increase rather than a decrease.
The statistics, in plain English
A p-value of 0.053 after correction sits just above the usual threshold, so the total dose saving may be real but is not proven. The 3D dose difference is robust.
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