Dual-phase angio-CT did not add radiation dose to intra-arterial liver procedures

Design

Retrospective single-centre comparison

Population

92 intra-arterial liver procedures (44 angio-CT, 48 cone-beam CT)

Primary outcome

3D and total effective dose

Effect

3D dose 9.85 vs 39.9 mSv; total 34.6 vs 55.9 mSv (corrected P = .053)

Hybrid suites with CT on rails (angio-CT) offer better image quality than C-arm cone-beam CT, but are often assumed to cost more radiation. This retrospective study compared 92 bland embolisation and radioembolisation mapping procedures: 44 with dual-phase angio-CT and 48 with single-phase cone-beam CT.

Fluoroscopy dose was similar. The 3D imaging dose was about four times lower with angio-CT (median 9.85 vs 39.9 mSv). Total effective dose was also lower (34.6 vs 55.9 mSv), but after correcting for uncertainty in dose conversion this difference was no longer significant (P = .053).

The fair reading is that angio-CT does not increase patient dose. Effective dose is estimated, not measured, and procedures were not randomised.

For units choosing equipment or protocols, dose concern is not a reason to avoid angio-CT.

• The 3D imaging dose was about four times lower with angio-CT than cone-beam CT.
• Total procedure dose was not significantly different after uncertainty correction.
• Effective dose was calculated from conversion factors, not measured directly.
• Record and audit dose-area and dose-length products for every procedure.

Why it matters

It removes a common objection to using dual-phase angio-CT where the suite allows it.

The statistics, in plain English

A P value of .053 after correction sits at the usual threshold, so the total-dose saving is uncertain. The 3D dose difference remained clear.

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