A retrospective comparison of organ dose and effective dose in percutaneous vertebroplasty performed under CT guidance or using a fixed C-arm with a flat-panel detector. (August 2021)

• Record Type: Journal Article
• Authors: Greffier, Joël; Hamard, Aymeric; Berny, Laure; Snene, Fehmi; Perolat, Romain; Larbi, Ahmed; Viala, Pierre; Dabli, Djamel; Beregi, Jean-Paul
• Is Part Of: Physica medica. Volume 88(2021)
• Page Start: 235
• Page End: 241
• Publication Date: 2021-08
• Subjects: AK Air Kerma -- CTDIvol Volume CT dose index -- DAP Dose area product -- DLP Dose length product -- E Effective dose -- PVP Percutaneous vertebroplasty; Vertebroplasty -- Multidetector computed tomography -- Interventional radiology -- Organ dose -- Effective dose; Medical physics -- Periodicals; Biophysics -- Periodicals; Biophysics -- Periodicals; Imagerie médicale -- Périodiques; Radiothérapie -- Périodiques; Rayons X -- Sécurité -- Mesures -- Périodiques; Physique -- Périodiques; Médecine -- Périodiques; 610.153
• DOI: 10.1016/j.ejmp.2021.07.002
• Languages: English
• ISSNs: 1120-1797

Abstract

Highlights: Effective dose was significantly higher for PVP performed under CT guidance. Organ doses were significantly higher with CT-scan than with fixed C-arm, except for oesophagus. From a dosimetry point of view, PVP should preferentially be performed with the fixed C-arm. Abstract: Purpose: To compare the organ-dose and effective-dose (E) delivered to the patient during percutaneous vertebroplasty (PVP) of one thoracic or lumbar vertebra performed under CT guidance or using a fixed C-arm. Methods: Consecutive adult patients undergoing PVP of one vertebra under CT-guidance, with optimized protocol and training of physicians, or using a fixed C-arm were retrospectively included from January 2016 to June 2017. Organ-doses were computed on 16 organs using CT Expo 2.4 software for the CT procedures and PCXMC 2.0 for the fixed C-arm procedures. E was also computed with both software. Dosimetric values per anatomic locations for all procedures were compared using the paired Mann-Whitney-Wilcoxon test. Results: In total, 73 patients were analysed (27 men and 46 women, mean age 78 ± 10 years) among whom 35 (48%) underwent PVP under CT guidance and 38 (52%) PVP using a fixed C-arm. The median E was 11.31 [6.54; 15.82] mSv for all PVPs performed under CT guidance and 5.58 [3.33; 8.71] mSv for fixed C-arm and the differences was significant (p<0.001). For lumbar PVP, the organ doses of stomach, liver and colon were significantly higher with CT-scan than with the fixed C-arm: 97% (p=0.02); 21% (p=0.099) and 375% (p=0.002), respectively. For thoracic PVP, the lung organ dose was significantly higher with CT-scan than with the fixed C-arm (127%; p<0.001) and the oesophagus organ doses were not significantly different (p = 0.626). Conclusion: This study showed that the E and the organ dose on directly exposed organs were both higher for PVP performed under CT-guidance than with the fixed C-arm.