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Body interventional procedures: which is the best method for CT guidance?

  • Jean-Philippe LustigEmail author
  • Sébastien Aubry
  • Chrystelle Vidal
  • Lionel Pazart
  • Alexandre Moreau-Gaudry
  • Ivan Bricault
Interventional
First Online:
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Abstract

Objectives

To compare sequential fluoroscopy guidance with spiral guidance in terms of safety, effectiveness, speed and radiation in interventional whole body procedures.

Methods

This study was a retrospective analysis of data from the prospective, randomised controlled, multicentre CTNAV2 study. The present analysis included 385 patients: 247 in the sequential group (SEQ) and 138 in the spiral group (SPI). Safety was assessed by the number of major complications. Effectiveness was measured according to the number of targets reached. Data on procedural time and radiation delivered to patients were also collected.

Results

There was no significant difference between the two groups (SEQ vs SPI) regarding the success rate (99.6% vs 99.3%, p = 0.680), procedural time (7 min 40 s ± 5 min 48 s vs 7 min 13 s ± 7 min 33 s, p = 0.507), or major complications (2.43% vs 5.8%, p = 0.101). Radiation dose to patients was 84% lower in the sequential group (54.8 ± 51.8 mGy cm vs 352.6 ± 404 mGy cm, p < 0.0001).

Conclusions

Sequential CT fluoroscopy-guided whole-body interventional procedures seems to be as safe, effective and fast as spiral guidance, while also yielding a significant decrease in the radiation dose to patients.

Key Points

• Sequential CT fluoroscopy and spiral acquisition are comparable in terms of safety, effectiveness and speed.

• Procedural times are comparable despite an increased number of acquisitions in sequential fluoroscopy.

• Radiation dose to patients is 84% lower in sequential fluoroscopy compared with spiral CT.

Keywords

Radiology, interventional Radiation dosage Fluoroscopy Tomography, X-ray computed 

Abbreviations

CEREES

Expert Committee for Research, Studies and Evaluations in the field of Health

CT

Computed tomography

CTDI

Computed Dosimetry Dose Index

CTF

Computed tomography fluoroscopy

CTNAV2

Computed Tomography NAVigation 2

DLP

Dose length product

MRI

Magnetic resonance imaging

NAV

Navigation

SEQ

Sequential group

SIR

Society of Interventional Radiology

SPI

Spiral group

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Notes

Funding information

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Pr Sébastien Aubry

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Patients had given written, informed consent during the CTNAV 2 study as part of a national hospital clinical research programme (ClinicalTrials.gov identifier: NCT01896219) that their health data could be used for other research purposes.

Ethical approval

This study was conducted on existing data from the CTNAV 2 study as part of a national hospital clinical research programme (ClinicalTrials.gov identifier: NCT01896219). The opinion of the Expert Committee for Research, Studies and Evaluations in the field of Health (CEREES) was therefore not required.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in : Rouchy RC, Moreau-Gaudry A, Chipon E, et al (2017) Evaluation of the clinical benefit of an electromagnetic navigation system for CT-guided interventional radiology procedures in the thoraco-abdominal region compared with conventional CT guidance (CTNAV II): study protocol for a randomised controlled trial. Trials 18:306. doi: 10.1186/s13063-017-2049-6

Methodology

• Retrospective

• Observational

• Multicentre study

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  1. 1.Department of RadiologyCHU BesanconBesanconFrance
  2. 2.Nanomedecine Laboratory, INSERM EA4662Université Bourgogne Franche-ComteBesanconFrance
  3. 3.Clinical Investigation Center, INSERM CIT808CHU BesanconBesanconFrance
  4. 4.Clinical Investigation Center - Innovative Technology INSERM 1406University Hospital, GrenobleLa TroncheFrance
  5. 5.Laboratory of Techniques for Biomedical Engineering and Complexity ManagementUniversity Grenoble Alpes, National Center for Scientific ResearchGrenobleFrance
  6. 6.Department of Radiology and Medical ImagingUniversity Hospital, GrenobleLa TroncheFrance

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