Analysis of Periprocedural X-ray Exposure in Transarterial Radioembolization with Glass or Resin Microspheres

oleh: Constantin Ehrengut, Johanna Vogt, Jakob Leonhardi, Emma Carabenciov, Felix Teske, Florian van Boemmel, Thomas Berg, Daniel Seehofer, Thomas Lincke, Osama Sabri, Holger Gößmann, Timm Denecke, Sebastian Ebel

Format: Article
Diterbitkan: MDPI AG 2023-12-01

Deskripsi

<b>Background</b>: Transarterial Radioembolization (TARE) is an effective treatment option for both primary and secondary liver malignancies. However, challenging anatomical conditions can lead to prolonged fluoroscopy times (FT), elevated doses of periprocedural X-radiation (DAP), and increased use of contrast agents (CAs). In this study, we examined the influence of our radiologists’ experience and the choice of microspheres on X-ray exposure and CA doses in TARE. <b>Material and Methods</b>: Datasets comprising 161 TARE and 164 preprocedural evaluation angiographies (TARE-EVA) were analyzed. Our study focused on assessing DAP, FT, and CA concerning both microsphere types, the radiologist’s experience, and whether the same radiologist performed both the TARE-EVA and the actual TARE. <b>Results:</b> In TARE, the use of resin microspheres resulted in significantly higher FT and CA compared to glass microspheres (14.3 ± 1.6 min vs. 10.6 ± 1.1 min and 43 ± 2.2 mL vs. 33.6 ± 2.1 mL, <i>p</i> < 0.05), with no notable differences in DAP (<i>p</i> = 0.13). Experienced radiologists demonstrated reduced FT/DAP, with a 19% decrease in DAP and 53% in FT during the evaluation angiography (<i>p</i> < 0.05) and a 49% reduction in DAP during the actual TARE (<i>p</i> < 0.05), with no statistical differences in FT. Performing TARE and TARE-EVA under the same radiologist led to a 43% reduction in DAP and a 25% decrease in FT (<i>p</i> < 0.05, respectively). <b>Conclusions:</b> To mitigate X-radiation exposure, it is advisable for radiologists to undergo thorough training, and, ideally, the same radiologist should conduct both the TARE and the TARE-EVA. While the use of glass spheres may decrease intraarterial CA, it does not significantly impact periprocedural X-ray exposure.