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Review
. 2022 Sep 13;22(1):165.
doi: 10.1186/s12880-022-00887-2.

Analysis of patient's X-ray exposure in hepatic chemosaturation procedures: a single center experience

Sebastian Ebel  1 , Martin Reinhardt  2 , Anne Bettina Beeskow  2 , Felix Teske  2 , Manuel Florian Struck  3 , Rhea Veelken  4 , Florian van Boemmel  4 , Thomas Berg  4 , Michael Moche  5 , Matthias Gutberlet  6 , Holger Gößmann  2 , Timm Denecke  2
Affiliations
Review

Analysis of patient's X-ray exposure in hepatic chemosaturation procedures: a single center experience

Sebastian Ebel et al. BMC Med Imaging. .

Abstract

Background: Hepatic chemosaturation is a technique in which a high dose of the chemotherapeutic agent melphalan is administered directly into the liver while limiting systemic side effects. We reviewed our institutional experience regarding patient's X-ray exposure caused by the procedure.

Methods: Fifty-five procedures, performed between 2016 and 2020 in 18 patients by three interventional radiologists (radiologist), were analyzed regarding the patient's exposure to radiation. Dose-area-product (DAP) and fluoroscopy time (FT) were correlated with the experience of the radiologist and whether the preprocedural evaluation (CS-EVA) and the procedure were performed by the same radiologist. Additionally, the impact of previous liver surgery on DAP/FT was analyzed.

Results: Experienced radiologist require less DAP/FT (50 ± 18 Gy*cm2/13.2 ± 3.84 min vs. 69 ± 20 Gy*cm2/15.77 ± 7.82 min; p < 0.001). Chemosaturations performed by the same radiologist who performed CS-EVA required less DAP/FT (41 ± 12 Gy*cm2/11.46 ± 4.41 min vs. 62 ± 11 Gy*cm2/15.55 ± 7.91 min; p < 0.001). Chemosaturations in patients with prior liver surgery with involvement of the inferior cava vein required significantly higher DAP/FT (153 ± 27 Gy*cm2/25.43 ± 4.57 min vs. 56 ± 25 Gy*cm2/14.44 ± 7.55 min; p < 0.001).

Conclusion: There is a significant learning curve regarding the procedure of hepatic chemosaturation. Due to dose reduction the evaluation and chemosaturation therapy should be performed by the same radiologist. Procedures in patients with previous liver surgery require higher DAP/FT.

Keywords: Chemosaturation; Inteventional radiology; Liver metastasis; Melanoma; Percutaneous hepatic perfusion; Regional therapy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Measurement of the length of the supra-hepatic inferior cava vein performed on an angiogram to check for proper sealing of the double balloon catheter
Fig. 2
Fig. 2
Box-plot comparison of the mean fluoroscopy time (min) overall and according to the radiologist experience. Significant differences are marked by *
Fig. 3
Fig. 3
Box-plot comparison of the mean dose area product overall and according to the radiologist experience. Significant differences are marked by *
Fig. 4
Fig. 4
Box-plot comparison of the mean fluoroscopy time and dose area product with respect. If the preprocedural evaluation (CS-EVA) and the procedure were performed by different radiologist or the same radiologist. Significant differences are marked by *
See this image and copyright information in PMC

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