Ruediger Egbert Schernthaner MD, Presenter: Nothing to Disclose

MingDe Lin PhD, Abstract Co-Author: Employee, Koninklijke Philips NV

Julius Chapiro MD, Abstract Co-Author: Nothing to Disclose

Rafael Duran MD, Abstract Co-Author: Nothing to Disclose

Boris Gorodetski, Abstract Co-Author: Nothing to Disclose

Jean-Francois H. Geschwind MD, Abstract Co-Author: Consultant, BTG International Ltd Consultant, Bayer AG Consultant, Guerbet SA Consultant, Nordion, Inc Grant, BTG International Ltd Grant, F. Hoffmann-La Roche Ltd Grant, Bayer AG Grant, Koninklijke Philips NV Grant, Nordion, Inc Grant, ContextVision AB Grant, CeloNova BioSciences, Inc Founder, PreScience Labs, LLC CEO, PreScience Labs, LLC

To investigate potential x-ray dose reduction, without compromising image quality, of fluoroscopy and digital subtraction angiography (DSA) of a new angiographic imaging system in patients undergoing intra-arterial therapy (IAT) for liver cancer.

In this ongoing prospective trial, 25 consecutive patients underwent hepatic IAT on a new imaging platform (AlluraClarity, Philips Healthcare, Best, The Netherlands). For detailed dose-logging, a radiation dose structured reporting (RDSR) system was setup that included air kerma (AK) and dose area product (DAP) for each run (fluoroscopy, digital subtraction angiography (DSA),single shot exposure and Cone Beam CT). The dose from this imaging platform was compared to 25 other consecutive patients who underwent similar procedures on the predecessor imaging platform (Allura, Philips Healthcare). DSA image quality for both imaging platforms was assessed on a five-rank-scale in a randomized and blinded fashion. Paired t-test was performed for BMI and fluoroscopy time, Mann-Whitney U test was used to compare image quality and dose of each type of run between the two imaging platforms.

Both patient cohorts showed no difference with regard to BMI (p=0.87) and fluoroscopy time (p=0.98). The new system resulted in a significant dose reduction in total AK and DAP of 58% and 60% compared to the old platform (median of 0.47 Gy and 143.41 Gy*cm2 vs. 1.12 Gy and 359.59 Gy*cm2, respectively (p<0.01)). Specifically, DAP for fluoroscopy and DSA decreased significantly by 60% and 77%, respectively (p<0.01). During the procedures, no relevant problems due to image quality were reported. Likewise, the blinded evaluation of image quality revealed no differences between the new and the old imaging platforms (mean score 1.16 vs 1.24; p=0.48).

The new imaging platform allowed for significant x-ray radiation dose reduction in patients undergoing IAT for liver cancer without compromising image quality.

During the last decade, the use of hepatic IAT has steadily increased. Thus, the reduction of x-ray dose for both patients and clinicians is essential for radiation protection.

Schernthaner, R, Lin, M, Chapiro, J, Duran, R, Gorodetski, B, Geschwind, J, Substantial X-ray Dose Reduction in Intra-arterial Therapy for Liver Cancer: A New Angiographic Imaging Technology.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011417.html