Ryan Michael Kohlbrenner MD, Presenter: Nothing to Disclose

Kanti Pallav Kolli MD, Abstract Co-Author: Research Grant, Koninklijke Philips NV

Andrew Grenville Taylor MD, PhD, Abstract Co-Author: Nothing to Disclose

Maureen Pearl Kohi MD, Abstract Co-Author: Nothing to Disclose

Nicholas Fidelman MD, Abstract Co-Author: Nothing to Disclose

Jeanne M. Laberge MD, Abstract Co-Author: Nothing to Disclose

Robert K. Kerlan MD, Abstract Co-Author: Nothing to Disclose

Robert G. Gould DSc, Abstract Co-Author: Research Grant, Koninklijke Philips NV

To compare the patient radiation doses during transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) performed with Philips Allura Xper versus Philips Allura Clarity imaging platforms.

Total fluoroscopy time, cumulative air kerma, and cumulative dose area product data were retrospectively collected for 129 TACE procedures performed to treat HCC. The first 85 procedures were performed in an interventional radiology suite equipped with the Philips Allura Xper imaging platform. The subsequent 44 procedures were performed in the same suite following installation of the Philips Allura Clarity imaging platform. To confirm similarities in patient size, the anteroposterior diameter of the upper abdomen at the level of the portal vein bifurcation was assessed on CT or MRI for all patients in both groups. Mean values were compared using two-tailed t-tests.

Following installation of the Philips Allura Clarity platform, a 43.7% reduction in mean cumulative dose area product (3033.2 versus 1707.2 mGy-cm2, p < 0.0001) and a 29.5% reduction in mean cumulative air kerma (1445.4 versus 1019.3 mGy, p < 0.001) were found in comparison to procedures performed with the Philips Allura Xper platform. Total fluoroscopy time was 20% greater (1679.3 versus 2015.7 seconds, p < .05) for procedures performed with Allura Clarity compared with Allura Xper. Patient size was similar between the two groups (Anteroposterior thickness of 268.4 versus 265.9 mm, p = .70).

The Philips Allura Clarity imaging acquisition and processing platform significantly reduces patient radiation dose when compared to Philips Allura Xper in patients of comparable size undergoing TACE for HCC treatment. Dose reduction was achieved despite an increase in average fluoroscopy time. Further studies are necessary to determine whether the increase in fluoroscopy time is related to image quality or bias in patient selection to treat more difficult cases in the new low-dose room.

TACE procedures can be successfully performed at patient radiation doses significantly below current norms.

Kohlbrenner, R, Kolli, K, Taylor, A, Kohi, M, Fidelman, N, Laberge, J, Kerlan, R, Gould, R, Patient Radiation Dose Reduction during Transarterial Chemoembolization Using a Novel X-ray Fluoroscopy Imaging Acquisition and Processing Platform.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009651.html