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Author Busser, Wendy M. H. ♦ Arntz, Mark J. ♦ Jenniskens, Sjoerd F. M. ♦ Deinum, Jaap ♦ Hoogeveen, Yvonne L. ♦ Lange, Frank de ♦ Schultze Kool, Leo J.
Source United States Department of Energy Office of Scientific and Technical Information
Content type Text
Language English
Subject Keyword RADIOLOGY AND NUCLEAR MEDICINE ♦ AIDS ♦ CAT SCANNING ♦ COMPARATIVE EVALUATIONS ♦ FLUOROSCOPY ♦ HYDROCORTISONE ♦ IMAGES ♦ PATIENTS ♦ RADIATION DOSES ♦ SAMPLING ♦ SKIN ♦ VEINS ♦ VERTEBRAE
Abstract PurposeWe assessed whether image registration of cone-beam computed tomography (CT) (CBCT) and contrast-enhanced CT (CE-CT) images indicating the locations of the adrenal veins can aid in increasing the success rate of first-attempts adrenal vein sampling (AVS) and therefore decreasing patient radiation dose.Materials and Methods CBCT scans were acquired in the interventional suite (Philips Allura Xper FD20) and rigidly registered to the vertebra in previously acquired CE-CT. Adrenal vein locations were marked on the CT image and superimposed with live fluoroscopy and digital-subtraction angiography (DSA) to guide the AVS. Seventeen first attempts at AVS were performed with image registration and retrospectively compared with 15 first attempts without image registration performed earlier by the same 2 interventional radiologists. First-attempt AVS was considered successful when both adrenal vein samples showed representative cortisol levels. Sampling time, dose-area product (DAP), number of DSA runs, fluoroscopy time, and skin dose were recorded.ResultsWithout image registration, the first attempt at sampling was successful in 8 of 15 procedures indicating a success rate of 53.3 %. This increased to 76.5 % (13 of 17) by adding CBCT and CE-CT image registration to AVS procedures (p = 0.266). DAP values (p = 0.001) and DSA runs (p = 0.026) decreased significantly by adding image registration guidance. Sampling and fluoroscopy times and skin dose showed no significant changes.ConclusionGuidance based on registration of CBCT and previously acquired diagnostic CE-CT can aid in enhancing localization of the adrenal veins thereby increasing the success rate of first-attempt AVS with a significant decrease in the number of used DSA runs and, consequently, radiation dose required.
ISSN 01741551
Educational Use Research
Learning Resource Type Article
Publisher Date 2015-08-15
Publisher Place United States
Journal Cardiovascular and Interventional Radiology
Volume Number 38
Issue Number 4


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