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Hybrid CT-angiography (Angio-CT) for combined CT and fluoroscopic procedures in interventional radiology enhances utilization

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the utilization of an angiography-CT (Angio-CT) system and its advantages for single patient encounters.

Methods

Interventions utilizing both CT and fluoroscopy to perform multiple procedures in a single encounter or single interventions using both were identified. Cases were stratified by complexity (defined by RVUs). Comparative analyses of room (TRoom) and total encounter (TEncounter) times were performed between non-complex bundled cases and controls.

Results

Between June 2018 and August 2019, 1108 procedures were performed via the Angio-CT system; 10% (114/1108) used both fluoroscopy and CT. 21% (24/114) Involved more than one procedure in a single encounter that required a CT-only and fluoroscopy-only bundled procedure. 59% (67/114) were non-complex, and 70% (80/114) were non-oncologic. 82.5% (14/17) of non-complex bundled procedures demonstrated TRoom below the mean of their respective controls; 52.8% (9/17) were 2 standard deviations below the control means. Pleural catheter placement following post-lung biopsy pneumothorax was the most common non-complex bundled case with a significant reduction in TRoom when performed via Angio-CT compared to control (99 vs. 163 min, p < 0.0001). There was a significant reduction in TEncounter for abdominopelvic drain placement procedures bundled with either (1) percutaneous nephrostomy tube evaluation with or without replacement, or (2) central venous catheter placement (211 min vs. 344 min, p < 0.001 and 231 min vs. 347 min, p < 0.05, respectively).

Conclusion

The primary use for the hybrid Angio-CT system was to perform non-oncologic and non-complex cases with potential reduction in TRoom and TEncounter for specific non-complex bundled cases.

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References

  1. Tanaka T, Arai Y, Inaba Y, et al. Current role of hybrid CT/angiography system compared with C-arm cone beam CT for interventional oncology. The British Journal of Radiology. 2014;87(1041):20140126.

    Article  CAS  Google Scholar 

  2. Feinberg N, Funaki B, Hieromnimon M, et al. Improved utilization following conversion of a fluoroscopy suite to hybrid CT/angiography system. Journal of Vascular and Interventional Radiology. 2020;31(11):1857–1863.

    Article  Google Scholar 

  3. Lionberg A, Nijhawan K, Navuluri R, et al. Hybrid angiography-CT for transarterial radioembolization: a pictorial essay. Abdominal Radiology. 2021;46(6):2850–2854.

    Article  Google Scholar 

  4. Marshall EL, Guajardo S, Sellers E, et al. Radiation dose during Transarterial radioembolization: A dosimetric comparison of cone-beam CT and angio-CT technologies. Journal of Vascular and Interventional Radiology. 2021;32(3):429–438.

    Article  Google Scholar 

  5. Office of the Federal Register NAaRA. Federal Register. 2003;68(158):49179–49228.

  6. Scientific B. 2017 Procedural Payment Guide: Hospital Inpatient, Hospital Outpatient, ASC and Physician Reimbursement Information. 2017. https://www.bostonscientific.com/content/dam/bostonscientific/Reimbursement/PI/2017/2017_PPG-CRV_441601-AA-JAN2017_FINAL.pdf. Published January 1st, 2017. Accessed April 7th, 2022.

  7. Matsumoto MM, Nijhawan K, Leef JA, Dorsey C, Ahmed O. Hybrid CT-angiography to facilitate lower extremity sharp venous recanalization: a novel approach to a common procedure. CVIR Endovascular. 2020;3(1):1–4.

    Article  Google Scholar 

  8. Puijk RS, Nieuwenhuizen S, van den Bemd BA, et al. Transcatheter CT hepatic arteriography compared with conventional CT fluoroscopy guidance in percutaneous thermal ablation to treat colorectal liver metastases: A single-center comparative analysis of 2 historical cohorts. Journal of Vascular and Interventional Radiology. 2020;31(11):1772–1783.

    Article  Google Scholar 

  9. Orth RC, Wallace MJ, Kuo MD, Radiology TACotSoI. C-arm cone-beam CT: general principles and technical considerations for use in interventional radiology. Journal of Vascular and Interventional Radiology. 2008;19(6):814–820.

  10. Leddy KM, Kaldenberg DO, Becker BW. Timeliness in ambulatory care treatment: an examination of patient satisfaction and wait times in medical practices and outpatient test and treatment facilities. The Journal of Ambulatory Care Management. 2003;26(2):138–149.

    Article  Google Scholar 

  11. Lemos P, Pinto A, Morais G, et al. Patient satisfaction following day surgery. Journal of Clinical Anesthesia. 2009;21(3):200–205.

    Article  Google Scholar 

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Authors and Affiliations

  1. Section of Interventional Radiology, Department of Radiology, The University of Chicago Medical Center, 5841 S. Maryland Ave, Chicago, IL, 60637, USA

    Daniel H. Kwak, Osman Ahmed, Karan Nijhawan, Divya Kumari & Mikin Patel

  2. Rowan School of Osteopathic Medicine, 42 E. Laurel Rd, Stratford, NJ, 08084, USA

    Hasan Habib

Authors
  1. Daniel H. Kwak
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  2. Osman Ahmed
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  3. Hasan Habib
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  4. Karan Nijhawan
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  5. Divya Kumari
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  6. Mikin Patel
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Corresponding author

Correspondence to Daniel H. Kwak.

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Conflict of interest

OA reports receiving speaker fees from Penumbra, Inari, Argon, Canon, Johnson and Johnson. OA is an Advisory Board Member for Boston Scientific, Johnson and Johnson, Medtronic, and Varian. OA receives research grant funding from Canon Medical. OA receives consulting fees from Asahi.

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Kwak, D.H., Ahmed, O., Habib, H. et al. Hybrid CT-angiography (Angio-CT) for combined CT and fluoroscopic procedures in interventional radiology enhances utilization. Abdom Radiol 47, 2704–2711 (2022). https://doi.org/10.1007/s00261-022-03576-4

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  • DOI: https://doi.org/10.1007/s00261-022-03576-4

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