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Comparing Effective Doses During Image-Guided Core Needle Biopsies with Computed Tomography Versus C-Arm Cone Beam CT Using Adult and Pediatric Phantoms

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Abstract

Purpose

To compare the effective doses of needle biopsies based on dose measurements and simulations using adult and pediatric phantoms, between cone beam c-arm CT (CBCT) and CT.

Method

Effective doses were calculated and compared based on measurements and Monte Carlo simulations of CT- and CBCT-guided biopsy procedures of the lungs, liver, and kidney using pediatric and adult phantoms.

Results

The effective doses for pediatric and adult phantoms, using our standard protocols for upper, middle and lower lungs, liver, and kidney biopsies, were significantly lower under CBCT guidance than CT. The average effective dose for a 5-year old for these five biopsies was 0.36 ± 0.05 mSv with the standard CBCT exposure protocols and 2.13 ± 0.26 mSv with CT. The adult average effective dose for the five biopsies was 1.63 ± 0.22 mSv with the standard CBCT protocols and 8.22 ± 1.02 mSv using CT. The CT effective dose was higher than CBCT protocols for child and adult phantoms by 803 and 590 % for upper lung, 639 and 525 % for mid-lung, and 461 and 251 % for lower lung, respectively. Similarly, the effective dose was higher by 691 and 762 % for liver and 513 and 608 % for kidney biopsies.

Conclusions

Based on measurements and simulations with pediatric and adult phantoms, radiation effective doses during image-guided needle biopsies of the lung, liver, and kidney are significantly lower with CBCT than with CT.

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References

  1. Silverman SG, Deuson TE, Kane NM. Percutaneous abdominal biopsy: cost-identification analysis. Radiology. 1998;206:429–35.

    Article  CAS  PubMed  Google Scholar 

  2. ICRP (The International Commission on Radiological Protection). Annals of the ICRP. Managing Patient Dose in Multi-Detector Computed Tomography (MDCT), Annals of the ICRP, ICRP Publication 102, Elsevier, Oxford, UK, 2007.

  3. Zacharias C, Alessio AM, Otto RK, Iyer RS, Philips GS, Swanson JO, Thapa MM. Pediatric CT: strategies to lower radiation dose. AJR. 2013;200:950–6.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Patel AS, Soares B, Courtier J, MacKenzie JD. Radiation dose reduction in pediatric CT-guided musculoskeletal procedures. Pediatr Radiol. 2013;43:1303–8.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Nelson TR. Practical strategies to reduce pediatric CT radiation dose. J Am Coll Radiogr. 2014;11(3):292–9.

    Article  Google Scholar 

  6. ICRP (The International Commission on Radiological Protection). Annals of the ICRP. Radiological Protection in Pediatric Diagnostic and Interventional Radiology, Annals of the ICRP, ICRP Publication 121. Elsevier, Oxford, UK, 2013.

  7. ICRP (The International Commission on Radiological Protection). Annals of the ICRP. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Elsevier, Oxford, UK, 2007.

  8. Alderson SW. United States Patent Office, 3,310,885, Patented Mar. 28, 1967.

  9. Tapiovaara M, Siiskonen T. A PC-based Monte Carlo Program for Calculating Patient Dose in Medical X-Ray Examinations. STUK—The Finnish Radiation and Nuclear Safety Authority. Report STUK-A139. Helsinki, Finland, 2007.

  10. Cristy M, Eckerman KF. Specific absorbed fractions of energy at various ages from internal photon sources. I Methods. Report ORNL/TM-8381/V1. Oak Ridge National Laboratory, Oak Ridge, USA, 1987.

  11. ICRP (The International Commission on Radiological Protection). Annals of the ICRP. Managing Patient Dose in Multi-Detector Computed Tomography (MDCT). ICRP Publication 102. Elsevier, Oxford, UK, 2007.

  12. Bongarts G, Golding SJ, Jurik AG, et al. European Guidelines for Multislice Computed Tomography, European Commission, 2004.

  13. Shrimpton PC, Hillier MC, Lewis MA, et al. National Survey of Doses in the UK: 2003. Br J Radiol. 2006;79(948):968–80.

    Article  CAS  PubMed  Google Scholar 

  14. IPEMB (Institution of Physics and Engineering in Medicine and Biology), Measurement of the performance characteristics of diagnostic X-Ray systems used in medicine, part I (2nd ed.): X-Ray tubes and generators. Report No. 32, York, UK, 1996.

  15. Ben-Shlomo A, Bartal G, Shabat S, Mosseri M. Effective dose and breast dose reduction in pediatric scoliosis x-ray radiography by optimal positioning. Radiat Prot Dosim. 2013;156(1):30–6.

    Article  CAS  Google Scholar 

  16. Hobson MA, Soisson ET, Davis SD, Parker W. Using the ACR CT accreditation phantom for routine image quality assurance on both CT and CBCT imaging systems in a radiotherapy environment. J Appl Clin Med Phys. 2014;15(4):4835. doi:10.1120/jacmp.v15i4.4835.

    PubMed  Google Scholar 

  17. Paul J, Chacko A, Farhang M, Kamali S, Tavanania M, Vogl T, Panahi B. Ultrafast cone-beam computed tomography: a comparative study of imaging protocols during image-guided therapy procedure. Biomed Res Int. 2015;2015:467850. doi:10.1155/2015/467850.

    Article  PubMed  PubMed Central  Google Scholar 

  18. XperCT, Instruction for Use, document version 2.1, Philips Medical Systems Nederland B.V., 2009.

  19. Hwang HS, Chung MJ, Lee JW, Shin SW, Lee KS. C-Arm Cone-Beam CT-guided percutaneous transthoracic lung biopsy: usefulness in evaluation of small pulmonary nodules. Am J Roentgenol. 2010;195(6):W400–7. doi:10.2214/AJR.09.3963.

    Article  Google Scholar 

  20. ICRP (The International Commission on Radiological Protection), Annals of the ICRP. Recommendations of the International Commission on Radiological Protection, ICRP Publication 60. Oxford: Pergamum Press; 1990 1991.

    Google Scholar 

  21. Strocchi S, Colli V, Conte L. Multidetector CT fluoroscopy and cone-beam CT-guided percutaneous transthoracic biopsy: comparison based on patient doses. Radiat Prot Dosim. 2012;151(1):162–5.

    Article  CAS  Google Scholar 

  22. Suzuki S, Furui S, Yamaguchi I, Yamagishi M, Watanab A, Abe T, Kobayashi I. Effective dose during abdominal three dimensional imaging with a flat panel detector angiography system. Radiology. 2009;250(2):545–50.

    Article  PubMed  Google Scholar 

  23. Braak SJ, Van Strijen MJL, Van Es HW, Nievelstein RAJ, Van Heesewijk JPM. Effective dose during needle interventions: cone-beam CT guidance compared with conventional CT guidance. J Vasc Interv Radiol. 2011;22:455–61.

    Article  PubMed  Google Scholar 

  24. ImPACT imaging performance assessment of CT scanners: a medical devices agency evaluation group. CT scanner matching data, tables of CTDI values in air, CTDIw, and phantom factor values. Version 1.0.2, 2009. ImPACT Internet home page: http://www.impactscan.org.

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Acknowledgments

We thank Ronit Burla for her excellent assistance with this article and Faye Schreiber for her noteworthy editorial assistance.

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Authors and Affiliations

  1. Radiation Protection Domain, Soreq NRC, Yavne, 81800, Israel

    A. Ben-Shlomo

  2. Section of Pediatric Cardiology, Schneider Children’s Medical Center, Petach Tikva, Israel

    D. Cohen, E. Bruckheimer & E. Birk

  3. Department of Diagnostic Radiology, Rabin Medical Center, Petach Tikva, Israel

    G. N. Bachar, R. Konstantinovsky & E. Atar

  4. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    E. Atar

Authors
  1. A. Ben-Shlomo
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  2. D. Cohen
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  3. E. Bruckheimer
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  4. G. N. Bachar
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  5. R. Konstantinovsky
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  6. E. Birk
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Correspondence to E. Atar.

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Ben-Shlomo, A., Cohen, D., Bruckheimer, E. et al. Comparing Effective Doses During Image-Guided Core Needle Biopsies with Computed Tomography Versus C-Arm Cone Beam CT Using Adult and Pediatric Phantoms. Cardiovasc Intervent Radiol 39, 732–739 (2016). https://doi.org/10.1007/s00270-015-1227-8

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  • DOI: https://doi.org/10.1007/s00270-015-1227-8

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