A study of dose indicators during intra-arterial catheter implantation for liver chemotherapy. (18th August 2021)

• Record Type: Journal Article
• Authors: Izaaryene, Jean; Golin, Melissa; Daidj, Nassima; Piana, Gilles; Ferre, Marjorie
• Is Part Of: Journal of radiological protection. Volume 41:Number 3(2021)
• Page Start: 495
• Page End: 511
• Publication Date: 2021-08-18
• Subjects: interventional radiology -- intra-arterial catheter -- liver -- dose indicators; Radiation -- Safety measures -- Periodicals; Health Physics -- Periodicals; Radiation Monitoring -- Periodicals; Radiation Protection -- Periodicals; Rayonnement -- Sécurité -- Mesures -- Périodiques; Electronic journals; Fulltext; Internet Resource; Periodical; 363.179905
• DOI: 10.1088/1361-6498/abf570
• Languages: English
• ISSNs: 0952-4746

Abstract

Abstract: The aim of the present study was to describe patient dose indicator levels during intra-arterial catheter (IAC) implantation for liver chemotherapy, and to determine factors affecting the dose indicators. Between January 2017 and January 2019, 61 patients with hepatic metastases from colorectal cancer were retrospectively included. Interventions were carried out in a standardised manner by three experienced radiologists on the same angiographic table without changes in protocol parameters. For each patient, clinical, radiological and dosimetry data were collected, including the air kerma area product (KAP), part of KAP due to the fluoroscopy and fluoroscopy time (FT), total kerma at the reference interventional point and peak skin dose (PSD). Local dose reference levels (RLs) were determined as the third quartile of the patient dose distributions. Univariate and multivariate analysis of factors affecting dose indicators was performed. The mean KAP was 111 Gy cm 2, the mean reference point air kerma (Ka, r) was 648 mGy, the mean PSD was 613 mGy, and the mean FT was 3190 s (62% of the KAP). The mean cone beam computed tomography dose was 37.3 ± 11.8 Gy cm 2, which accounted for 37% of the KAP. The RL could be proposed taking into account the third quartiles (KAP = 164.6 Gy cm 2, Ka, r = 904.5 mGy, FT = 4011 s and standard deviation = 772.7 mGy). The factors affecting dose indicators were related to the patients (sex, cardiovascular risk factors, weight, body mass index), to the vascular anatomies (coeliac trunk angulation) and to the procedures (number of embolised arteries). This study allowed a better understanding of dose indicators and factors affecting these indicators during the implantation of IACs for hepatic chemotherapy, which is a long and difficult procedure. Local dose RLs were determined. Multicentre, multi-equipment studies are necessary.