Digital flat-panel UFE guidance cuts skin radiation dose

Apr 5, 2005

NEW ORLEANS - Radiation exposure during uterine fibroid embolization (UFE) procedures can be cut in half by using a digital flat-panel system in dynamic mode for guidance, according to a presentation Monday at the Society of Interventional Radiology (SIR) meeting.

"The increase in UFE procedures over the last five to 10 years has been paralleled by a sharp increase in radiation skin burns in women," said Dr. Gerald Niedzwiecki of Mease Countryside Hospital in Safety Harbor, FL. The FDA has suggested setting a threshold radiation dose for UFE, and interventional radiologists are experimenting with ways to limit exposure, Niedzwiecki said.

Advanced dynamic image processing modes on a digital flat-panel x-ray system (Innova 4100, GE Healthcare, Chalfont St. Giles, U.K.) provide improved visualization of contrast-filled vasculature, while also dramatically reducing radiation dose, he said. In previous research, Niedzwiecki's group found that dynamic mode (DM) sequences provided adequate diagnostic image quality when compared to higher-dose digital subtraction angiography (DSA) in UFE.

For the current study, the group compared radiation dose in DSA-guided versus DM-guided UFE. Fluoroscopy time and cumulative dose-area product values were recorded for each case.

A total of 20 cases were analyzed and half were sequenced with DM. "There were significant differences in cumulative patient dose-area product. With DSA the dose was 13,305 cGycm², but this came down to 6,680 cGycm² with DM," Niedzwiecki said.

There were no significant differences in fluoro time (5.5 versus 5.7 minutes), BMI (27.6 versus 26), or age (59 versus 61) between the two treatment groups.

When asked if there was a reduction in radiation dose to the operator, Niedzwiecki said his group planned to study the question in the future. He also said that patients are told about radiation dose in their informed consent documents.

By Peggy Peck
AuntMinnie.com contributing writer
April 6, 2005

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