Estimated effective dose of CT-guided percutaneous cryoablation of liver tumors

Abstract

Purpose: To estimate effective dose during CT-guided cryoablation of liver tumors, and to assess which procedural factors contribute most to dose. Materials and methods: Our institutional review board approved this retrospective, HIPAA-compliant study. A total of 20 CT-guided percutaneous liver tumor cryoablation procedures were performed in 18 patients. Effective dose was determined by multiplying the dose length product for each CT scan obtained during the procedure by a conversion factor (0.015 mSv/mGy-cm), and calculating the sum for each phase of the procedure: planning, targeting, monitoring, and post-ablation survey. Effective dose of each phase was compared using a repeated measures analysis. Using Spearman correlation coefficients, effective doses were correlated with procedural factors including number of scans, ratio of targeting distance to tumor size, anesthesia type, number of applicators, performance of ancillary procedures (hydrodissection and biopsy), and use of CT fluoroscopy. Results: Effective dose per procedure was 72 ± 18 mSv. The effective dose of targeting (37.5 ± 12.5 mSv) was the largest component compared to the effective dose of the planning phase (4.8 ± 2.2 mSv), the monitoring phase (25.5 ± 6.8 mSv), and the post-ablation survey (4.1 ± 1.9 mSv) phase (p < 0.05). Effective dose correlated positively only with the number of scans (p < 0.01). Conclusions: The effective dose of CT-guided percutaneous cryoablation of liver tumors can be substantial. Reducing the number of scans during the procedure is likely to have the greatest effect on lowering dose.