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. 2023 Nov 30;9(12):267.
doi: 10.3390/jimaging9120267.

Patient Dose Estimation in Computed Tomography-Guided Biopsy Procedures

Evangelia Siomou  1 , Dimitrios K Filippiadis  2 , Efstathios P Efstathopoulos  2 , Ioannis Antonakos  2 , George S Panayiotakis  1
Affiliations

Patient Dose Estimation in Computed Tomography-Guided Biopsy Procedures

Evangelia Siomou et al. J Imaging. .

Abstract

This study establishes typical Diagnostic Reference Levels (DRL) values and assesses patient doses in computed tomography (CT)-guided biopsy procedures. The Effective Dose (ED), Entrance Skin Dose (ESD), and Size-Specific Dose Estimate (SSDE) were calculated using the relevant literature-derived conversion factors. A retrospective analysis of 226 CT-guided biopsies across five categories (Iliac bone, liver, lung, mediastinum, and para-aortic lymph nodes) was conducted. Typical DRL values were computed as median distributions, following guidelines from the International Commission on Radiological Protection (ICRP) Publication 135. DRLs for helical mode CT acquisitions were set at 9.7 mGy for Iliac bone, 8.9 mGy for liver, 8.8 mGy for lung, 7.9 mGy for mediastinal mass, and 9 mGy for para-aortic lymph nodes biopsies. In contrast, DRLs for biopsy acquisitions were 7.3 mGy, 7.7 mGy, 5.6 mGy, 5.6 mGy, and 7.4 mGy, respectively. Median SSDE values varied from 7.6 mGy to 10 mGy for biopsy acquisitions and from 11.3 mGy to 12.6 mGy for helical scans. Median ED values ranged from 1.6 mSv to 5.7 mSv for biopsy scans and from 3.9 mSv to 9.3 mSv for helical scans. The study highlights the significance of using DRLs for optimizing CT-guided biopsy procedures, revealing notable variations in radiation exposure between helical scans covering entire anatomical regions and localized biopsy acquisitions.

Keywords: CT-guided biopsies; diagnostic reference levels; patient dose.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Box plots of the distribution of CTDIvol values for CT-guided procedures at helical acquisitions.
Figure 2
Figure 2
Box plots of the distribution of CTDIvol values for CT-guided procedures at biopsy acquisitions.
Figure 3
Figure 3
Box plots of the distribution of DLP values for CT-guided procedures at helical acquisitions.
Figure 4
Figure 4
Box plots of the distribution of DLP values for CT-guided procedures at biopsy acquisitions.
Figure 5
Figure 5
Distribution of (a) ESD (mGy) and (b) ED (mSv) at helical and biopsy mode of CT-guided Iliac bone biopsy procedure.
Figure 6
Figure 6
Distribution of (a) ESD (mGy) and (b) ED (mSv) at helical and biopsy mode of CT-guided liver biopsy procedure.
Figure 7
Figure 7
Distributions of (a) ESD (mGy) and (b) ED (mSv) at helical and biopsy mode of CT-guided lung biopsy procedure.
Figure 8
Figure 8
Distribution of (a) ESD (mGy) and (b) ED (mSv) at helical and biopsy mode of CT-guided mediastinum biopsy procedure.
Figure 9
Figure 9
Distribution of (a) ESD (mGy) and (b) ED (mSv) at helical and biopsy mode of CT-guided para-aortic lymph nodes biopsy procedure.
Figure 10
Figure 10
Typical DRL values in terms of CTDIvol (mGy) at helical and biopsy scans for CT-guided biopsies.
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