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CT-Guided Intervention with Low Radiation Dose: Feasibility and Experience

¹ Department of Radiology, Division of Body Imaging, Boston University Medical Center, 88 E Newton St., Atrium 2, Boston, MA 02118.
² Present address: Department of Radiology, Boston Veterans Administration Healthcare System, West Roxbury, MA.
³ Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA.

OBJECTIVE. The purpose of this study was to evaluate the feasibility of performing CT-guided interventional procedures with a very low radiation dose.

MATERIALS AND METHODS. We performed 291 CT-guided interventional procedures using a low dose of radiation. The subjects were 165 men and 126 women 22-89 years old with a mean age of 65 years. CT fluoroscopy was not used. The procedures were 201 percutaneous biopsies and 90 percutaneous aspiration or drainage procedures. Before the procedure, images were obtained with standard mAs of 175-250 mAs. All subsequent CT was performed at a reduced mAs. Technical success of catheter placement and biopsy was calculated, and the results were compared with those of procedures performed over the previous 12 months with standard radiation doses. Patient weight, lesion size, and number of CT acquisitions needed to complete the procedure were recorded.

RESULTS. All but three aspiration or drainage procedures performed at 30 mAs were successful, for a success rate of 96.7%. The technical success rate of biopsy performed at 30 mAs was 93.5%. In the cases of 13 patients undergoing biopsy, the masses were not identified with low-dose technique, and these procedures were completed at a higher dose. Results were independent of patient weight and lesion size. The technical success rate was 98% for percutaneous drainage performed at a standard radiation dose in the 12 months before introduction of the low-dose technique. The technical success rate was 87.5% for biopsy performed at a standard radiation dose in the 12 months before introduction of the low-dose technique. The complication rate of the low-dose technique was comparable to that of the standard-dose technique.

CONCLUSION. Low-dose radiation technique using 30 mAs results in technical success for both catheter placement and percutaneous biopsy comparable to standard radiation dose.

Keywords: biopsy • CT technique • interventional radiology • radiation dose

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