Abstract
Objectives
To evaluate patient radiation dose during intra-arterial liver procedures using Computed Tomography angiography (angio-CT) compared with C-arm Cone-Beam CT (CBCT).Material and methods
This retrospective study included bland embolization and radioembolization mapping procedures performed between November 2021 and December 2024 using dual-phase angio-CT or single-phase CBCT on a hybrid angiography suite. Effective dose was calculated by converting dose-area and dose-length product using conversion factors. Fluoroscopy-only (2D), CBCT/angio-CT (3D) effective dose and total effective dose were compared using the Mann-Whitney U-test. Bootstrap resampling and permutation testing with Monte Carlo error propagation were applied to assess the robustness of 3D and total effective dose comparisons.Results
Ninety-two procedures were included: 48 in the CBCT group and 44 in the angio-CT group. The 2D effective dose was comparable. The 3D effective dose was 4.1-fold lower in the angio-CT group (median 9.85 [IQR: 5.37-22.6 mSv] vs 39.9 mSv [IQR: 21.2-69.6 mSv], p Conclusion
Hybrid angiography suites incorporating angio-CT significantly reduced 3D effective dose compared to single-phase CBCT imaging. However, the total effective dose did not remain significant after uncertainty correction. Therefore, the use of angiography suites incorporating dual-phase angio-CT does not appear to change patient radiation exposure during intra-arterial liver procedures.Key points
Question What is the effect of integrating angio-CT into hybrid angiography suites on patient radiation exposure? Findings Dual-phase angio-CT integration into intra-arterial liver therapy workflows does not increase overall procedural radiation exposure and is associated with a decreased 3D effective dose. Clinical relevance Angio-CT offers several clinical advantages, and existing literature demonstrates improved image quality compared with CBCT. This study shows that dual-phase angio-CT does not increase patient radiation exposure compared to single-phase CBCT, supporting its use when available.