Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Abdominal Radiology
Published in: Abdominal Radiology 4/2016

01-04-2016 | Review Paper

Practical dose reduction tips for abdominal interventional procedures using CT-guidance

Authors: Ramit Lamba, Michael T. Corwin, Ghaneh Fananapazir

Published in: Abdominal Radiology | Issue 4/2016

Login to get access

Abstract

Reducing the radiation dose should be an endeavor not only for diagnostic CT exams but also for interventional procedures using CT-guidance. Given that interventional procedures vary in scope and complexity, there is greater variability in radiation doses delivered during CT procedures. The goal in an interventional procedure is simply to advance the interventional instruments into the target lesions, and as such diagnostic level doses are not required and only narrow scan range scans need to be acquired. Adherence to the principles outlined in this article will allow such procedures to be performed with reduced radiation doses.
Literature
1.
2.
3.
Hara AK, et al. (2013) Reducing body CT radiation dose: beyond just changing the numbers. AJR Am J Roentgenol 201(1):33–40CrossRefPubMed
4.
Kubo T, et al. (2008) Radiation dose reduction in chest CT: a review. AJR Am J Roentgenol 190(2):335–343CrossRefPubMed
5.
McCollough CH, et al. (2012) Achieving routine submillisievert CT scanning: report from the summit on management of radiation dose in CT. Radiology 264(2):567–580CrossRefPubMedPubMedCentral
6.
7.
Chintapalli KN, et al. (2012) Radiation dose management: part 1, minimizing radiation dose in CT-guided procedures. AJR Am J Roentgenol 198(4):W347–W351CrossRefPubMed
8.
Lamba R (2014) Radiation dose optimization for CT-guided interventional procedures in the abdomen and pelvis. J Am Coll Radiol 11(3):279–284CrossRefPubMed
9.
Lucey BC, et al. (2007) CT-guided intervention with low radiation dose: feasibility and experience. AJR Am J Roentgenol 188(5):1187–1194CrossRefPubMed
10.
Sarti M, Brehmer WP, Gay SB (2012) Low-dose techniques in CT-guided interventions. Radiographics 32(4):1109–1119 (discussion 1119–1120)CrossRefPubMed
11.
Tam AL, et al. (2015) JOURNAL CLUB: standardizing CT-guided biopsy procedures: patient dose and image noise. AJR Am J Roentgenol 205(4):W390–W399CrossRefPubMed
12.
Leng S, et al. (2011) Radiation dose reduction for CT-guided renal tumor cryoablation. AJR Am J Roentgenol 196(5):W586–W591CrossRefPubMed
13.
14.
Tsapaki V, et al. (2014) Radiation dose in repeated CT guided radiofrequency ablations. Phys Med 30(1):128–131CrossRefPubMed
15.
Gervais DA, et al. (2004) Percutaneous imaging-guided abdominal and pelvic abscess drainage in children. Radiographics 24(3):737–754CrossRefPubMed
16.
McNeeley MF, et al. (2012) Percutaneous drainage of intra-abdominal abscess in children with perforated appendicitis. Pediatr Radiol 42(7):805–812CrossRefPubMed
17.
Leng S, et al. (2011) Radiation dose levels for interventional CT procedures. AJR Am J Roentgenol 197(1):W97–W103CrossRefPubMed
18.
Shepherd TM, et al. (2011) Reducing patient radiation dose during CT-guided procedures: demonstration in spinal injections for pain. AJNR Am J Neuroradiol 32(10):1776–1782CrossRefPubMed
19.
Tsalafoutas IA, et al. (2007) CT-guided interventional procedures without CT fluoroscopy assistance: patient effective dose and absorbed dose considerations. AJR Am J Roentgenol 188(6):1479–1484CrossRefPubMed
20.
Larson DB, Strauss KJ, Podberesky DJ (2015) Toward large-scale process control to enable consistent CT radiation dose optimization. AJR Am J Roentgenol 204(5):959–966CrossRefPubMed
21.
Levesque VM, et al. (2015) Radiation dose during CT-guided percutaneous cryoablation of renal tumors: effect of a dose reduction protocol. Eur J Radiol 84(11):2218–2221CrossRefPubMed
22.
Sheafor DH, et al. (1998) Abdominal percutaneous interventional procedures: comparison of CT and US guidance. Radiology 207(3):705–710CrossRefPubMed
23.
Mayo-Smith WW, et al. (2014) How i do it: managing radiation dose in CT. Radiology 273(3):657–672CrossRefPubMed
24.
25.
Kloeckner R, et al. (2013) Radiation exposure in CT-guided interventions. Eur J Radiol 82(12):2253–2257CrossRefPubMed
26.
Yueh N, et al. (1989) Gantry tilt technique for CT-guided biopsy and drainage. J Comput Assist Tomogr 13(1):182–184CrossRefPubMed
27.
Yamagami T, et al. (2004) Percutaneous needle biopsy for small lung nodules beneath the rib under CT scan fluoroscopic guidance with gantry tilt. Chest 126(3):744–747CrossRefPubMed
28.
Moser C, et al. (2013) A novel Laser Navigation System reduces radiation exposure and improves accuracy and workflow of CT-guided spinal interventions: a prospective, randomized, controlled, clinical trial in comparison to conventional freehand puncture. Eur J Radiol 82(4):627–632CrossRefPubMed
29.
Silverman SG, et al. (1999) CT fluoroscopy-guided abdominal interventions: techniques, results, and radiation exposure. Radiology 212(3):673–681CrossRefPubMed
30.
Nawfel RD, et al. (2000) Patient and personnel exposure during CT fluoroscopy-guided interventional procedures. Radiology 216(1):180–184CrossRefPubMed
31.
Carlson SK, et al. (2003) Intermittent-mode CT fluoroscopy-guided biopsy of the lung or upper abdomen with breath-hold monitoring and feedback: system development and feasibility. Radiology 229(3):906–912CrossRefPubMed
32.
Carlson SK, et al. (2005) CT fluoroscopy-guided biopsy of the lung or upper abdomen with a breath-hold monitoring and feedback system: a prospective randomized controlled clinical trial. Radiology 237(2):701–708CrossRefPubMed
33.
34.
Shyn PB, et al. (2011) Minimizing image misregistration during PET/CT-guided percutaneous interventions with monitored breath-hold PET and CT acquisitions. J Vasc Interv Radiol 22(9):1287–1292CrossRefPubMed
35.
Katsuda T, Kuroda C, Fujita M (1997) Reducing misregistration of mask image in hepatic DSA. Radiol Technol 68(6):487–490PubMed
36.
Holland AE, Goldfarb JW, Edelman RR (1998) Diaphragmatic and cardiac motion during suspended breathing: preliminary experience and implications for breath-hold MR imaging. Radiology 209(2):483–489CrossRefPubMed
37.
Sainani NI, Arellano RS, Shyn PB, et al. (2013) The challenging image-guided abdominal mass biopsy: established and emerging techniques ‘if you can see it, you can biopsy it’. Abdom Imaging 38(4):672–696CrossRefPubMed
38.
Bushberg JT, et al. (2013) The essential physics of medical imaging, third edition. Med Phys 40(7):077301CrossRef
39.
Kalender WA (2011) Computed tomography: fundamentals, S.T., image quality, applications, 3rd edn. Erlangen: Publicis Publishing
40.
Maldjian PD, Goldman AR (2013) Reducing radiation dose in body CT: a primer on dose metrics and key CT technical parameters. AJR Am J Roentgenol 200(4):741–747CrossRefPubMed
41.
Reid J, et al. (2010) Optimization of kVp and mAs for pediatric low-dose simulated abdominal CT: is it best to base parameter selection on object circumference? AJR Am J Roentgenol 195(4):1015–1020CrossRefPubMed
42.
Dong F, et al. (2012) Optimization of kilovoltage and tube current-exposure time product based on abdominal circumference: an oval phantom study for pediatric abdominal CT. AJR Am J Roentgenol 199(3):670–676CrossRefPubMed
43.
Dixon RG, Ogden K (2010) Optimizing dose in computed tomographic guided procedures. Tech Vasc Interv Radiol 13(3):172–175CrossRefPubMed
44.
Menke J (2005) Comparison of different body size parameters for individual dose adaptation in body CT of adults. Radiology 236(2):565–571CrossRefPubMed
45.
Boone JM (2005) What parameters are most accurate in predicting appropriate technique factors for CT scanning? Radiology 236(2):377–378CrossRefPubMed
46.
Lira D, et al. (2015) Tube potential and CT radiation dose optimization. AJR Am J Roentgenol 204(1):W4–W10CrossRefPubMed
47.
Chang KJ, et al. (2013) Reducing radiation dose at CT colonography: decreasing tube voltage to 100 kVp. Radiology 266(3):791–800CrossRefPubMed
48.
Gonzalez-Guindalini FD, et al. (2013) MDCT of chest, abdomen, and pelvis using attenuation-based automated tube voltage selection in combination with iterative reconstruction: an intrapatient study of radiation dose and image quality. AJR Am J Roentgenol 201(5):1075–1082CrossRefPubMed
49.
Mayer C, et al. (2014) Potential for radiation dose savings in abdominal and chest CT using automatic tube voltage selection in combination with automatic tube current modulation. AJR Am J Roentgenol 203(2):292–299CrossRefPubMed
50.
Rezazadeh S, Co SJ, Bicknell S (2014) Reduced kilovoltage in computed tomography-guided intervention in a community hospital: effect on the radiation dose. Can Assoc Radiol J 65(4):345–351CrossRefPubMed
51.
Hara AK, et al. (2009) Iterative reconstruction technique for reducing body radiation dose at CT: feasibility study. AJR Am J Roentgenol 193(3):764–771CrossRefPubMed
52.
Sagara Y, et al. (2010) Abdominal CT: comparison of low-dose CT with adaptive statistical iterative reconstruction and routine-dose CT with filtered back projection in 53 patients. AJR Am J Roentgenol 195(3):713–719CrossRefPubMed
53.
Hu XH, et al. (2011) Radiation dose of non-enhanced chest CT can be reduced 40% by using iterative reconstruction in image space. Clin Radiol 66(11):1023–1029CrossRefPubMed
54.
Padole A, et al. (2015) CT radiation dose and iterative reconstruction techniques. AJR Am J Roentgenol 204(4):W384–W392CrossRefPubMed
55.
Tzedakis A, et al. (2005) The effect of z overscanning on patient effective dose from multidetector helical computed tomography examinations. Med Phys 32(6):1621–1629CrossRefPubMed
56.
Schilham A, et al. (2010) Overranging at multisection CT: an underestimated source of excess radiation exposure. Radiographics 30(4):1057–1067CrossRefPubMed
57.
Deak PD, et al. (2009) Effects of adaptive section collimation on patient radiation dose in multisection spiral CT. Radiology 252(1):140–147CrossRefPubMed
58.
Nickoloff EL, Khandji A, Dutta A (2000) Radiation doses during CT fluoroscopy. Health Phys 79(6):675–681CrossRefPubMed
59.
Carlson SK, et al. (2001) Benefits and safety of CT fluoroscopy in interventional radiologic procedures. Radiology 219(2):515–520CrossRefPubMed
60.
Paulson EK, et al. (2001) CT fluoroscopy–guided interventional procedures: techniques and radiation dose to radiologists. Radiology 220(1):161–167CrossRefPubMed
61.
Weir VJ, Zhang J, Bruner AP (2014) Impact of physician practice on patient radiation dose during CT guided biopsy procedures. J Xray Sci Technol 22(3):309–319PubMed
62.
Amrhein TJ, et al. (2016) Reducing patient radiation exposure from CT fluoroscopy-guided lumbar spine pain injections by targeting the planning CT. AJR Am J Roentgenol 206(2):390–394CrossRefPubMed
Metadata
Title
Practical dose reduction tips for abdominal interventional procedures using CT-guidance
Authors
Ramit Lamba
Michael T. Corwin
Ghaneh Fananapazir
Publication date
01-04-2016
Publisher
Springer US
Published in
Abdominal Radiology / Issue 4/2016
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-016-0670-6

Other articles of this Issue 4/2016

Abdominal Radiology 4/2016 Go to the issue

Pictorial Essay

Interventional oncology: pictorial review of post-ablation imaging of liver and renal tumors

OriginalPaper

Microwave ablation for liver tumors

Introduction

Introduction to the special section on interventional abdominal radiology

Pictorial essay

Hepatic imaging following intra-arterial embolotherapy

OriginalPaper

Difficult biopsy and drainage: just say yes

Classics in Abdominal Imaging

The small bowel feces sign
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits