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First experiences of a low-dose protocol for CT-guided musculoskeletal biopsies combining different radiation dose reduction techniques
Karolinska Univ Hosp, Funct Unit Musculoskeletal Radiol Funct Imaging &, S-17176 Stockholm, Sweden.;Karolinska Inst, Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden..ORCID iD: 0000-0002-7243-8170
Karolinska Inst, Inst Mol Med & Surg MMK, Diagnost Radiol, Stockholm, Sweden..
KTH, School of Engineering Sciences (SCI), Physics.
Karolinska Univ Hosp, Funct Unit Musculoskeletal Radiol Funct Imaging &, S-17176 Stockholm, Sweden..
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2020 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 61, no 1, p. 28-36Article in journal (Refereed) Published
Abstract [en]

Background The use of computed tomography (CT) for image guidance during biopsies is a powerful approach. The method is, however, often associated with a significant level of radiation exposure to the patient and operator. Purpose To investigate if a low-dose protocol for CT-guided musculoskeletal (MSK) biopsies, including a combination of different radiation dose (RD) techniques, is feasible in a clinical setting. Material and Methods Fifty-seven patients underwent CT-guided fine-needle aspiration cytology (FNAC) utilizing the low-dose protocol (group A). A similar number of patients underwent CT-guided FNAC using the reference protocol (group B). Between-group comparisons comprised radiation dose, success rate, image quality parameters, and workflow. Results In group A, the mean total dose-length product (DLP) was 41.2 +/- 2.9 mGy*cm, which was statistically significantly lower than of group B (257.4 +/- 22.0 mGy*cm), corresponding to a mean dose reduction of 84% (P<0.001). The mean CTDIvol for the control scans were 1.88 +/- 0.09 mGy and 13.16 +/- 0.40 mGy for groups A and B, respectively (P < 0.001). The success rate in group A was 91.2% and 87.9% in group B (P = 0.56). No negative effect on image-quality parameters, time of FNAC, and number of control scans were found. Conclusion We successfully developed a low-dose protocol for CT-guided MSK biopsies that maintains diagnostic accuracy and image quality at a fraction of the RD compared to the reference biopsy protocol at our clinic.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD , 2020. Vol. 61, no 1, p. 28-36
Keywords [en]
Image-guided biopsy, interventional radiology, multidetector computed tomography, musculoskeletal system, radiation dosage
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:kth:diva-266536DOI: 10.1177/0284185119847676ISI: 000504598500004PubMedID: 31091966Scopus ID: 2-s2.0-85067019620OAI: oai:DiVA.org:kth-266536DiVA, id: diva2:1391050
Note

QC 20200203

Available from: 2020-02-03 Created: 2020-02-03 Last updated: 2020-02-03Bibliographically approved

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