Highlights
- •Effective dose was significantly higher for PVP performed under CT guidance.
- •Organ doses were significantly higher with CT-scan than with fixed C-arm, except for oesophagus.
- •From a dosimetry point of view, PVP should preferentially be performed with the fixed C-arm.
Abstract
Purpose
To compare the organ-dose and effective-dose (E) delivered to the patient during percutaneous
vertebroplasty (PVP) of one thoracic or lumbar vertebra performed under CT guidance
or using a fixed C-arm.
Methods
Consecutive adult patients undergoing PVP of one vertebra under CT-guidance, with
optimized protocol and training of physicians, or using a fixed C-arm were retrospectively
included from January 2016 to June 2017. Organ-doses were computed on 16 organs using
CT Expo 2.4 software for the CT procedures and PCXMC 2.0 for the fixed C-arm procedures.
E was also computed with both software. Dosimetric values per anatomic locations for
all procedures were compared using the paired Mann-Whitney-Wilcoxon test.
Results
In total, 73 patients were analysed (27 men and 46 women, mean age 78 ± 10 years)
among whom 35 (48%) underwent PVP under CT guidance and 38 (52%) PVP using a fixed
C-arm. The median E was 11.31 [6.54; 15.82] mSv for all PVPs performed under CT guidance
and 5.58 [3.33; 8.71] mSv for fixed C-arm and the differences was significant (p<0.001).
For lumbar PVP, the organ doses of stomach, liver and colon were significantly higher
with CT-scan than with the fixed C-arm: 97% (p=0.02); 21% (p=0.099) and 375% (p=0.002),
respectively. For thoracic PVP, the lung organ dose was significantly higher with
CT-scan than with the fixed C-arm (127%; p<0.001) and the oesophagus organ doses were
not significantly different (p = 0.626).
Conclusion
This study showed that the E and the organ dose on directly exposed organs were both
higher for PVP performed under CT-guidance than with the fixed C-arm.
Abbreviations:
AK (Air Kerma), CTDIvol (Volume CT dose index), DAP (Dose area product), DLP (Dose length product), E (Effective dose), PVP (Percutaneous vertebroplasty)Keywords
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Article info
Publication history
Published online: July 23, 2021
Accepted:
July 4,
2021
Received in revised form:
July 2,
2021
Received:
March 25,
2021
Identification
Copyright
© 2021 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
