Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty
Yıl: 2019 Cilt: 25 Sayı: 5 Sayfa Aralığı: 353 - 359 Metin Dili: İngilizce DOI: 10.5152/dir.2019.18362 İndeks Tarihi: 24-10-2020
Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty
Öz: PURPOSEPercutaneous cementoplasty is a minimally invasive treatment modality for painful osteoporoticand pathologic sacral and supra-acetabular iliac fractures. This study compares the use of lowdose CT guidance with CT/CT fluoroscopy in sacral and supra-acetabular cementoplasty.METHODSA retrospective review of patients who had undergone sacral or supra-acetabular cementoplastywas performed with patients grouped by use of CT/CT fluoroscopy or low-dose CT guidanceduring the procedure. Parameters evaluated included type of fracture, laterality of lesions, painscores, pain medication use, imaging parameters, procedure time, dose-length product, effective dose, cement volume, and complications.RESULTSThere were 17 patients identified who underwent cementoplasty utilizing dual CT/CT fluoroscopy, while 13 patients had their procedures performed with low-dose CT. There was a statisticallysignificant decrease in radiation dose in the low-dose CT group (1481 mGy·cm) compared withthe CT/CT fluoroscopy group (2809 mGy·cm) (P = 0.013). There was a significant decrease in procedure time with low-dose CT for bilateral lesions (P = 0.016). There was no significant differencebetween groups in complication rate (P = 0.999). Clinically nonsignificant cement extravasationoccurred in two patients (10%) in the CT/CT fluoroscopy group and in one patient (8%) in thelow-dose CT group (P = 0.999). There was a significant decrease in pain scores compared withbaseline on the visual analogue scale in both groups at 1 week (low-dose CT P = 0.002, CT/CTfluoroscopy P = 0.008) and 1 month postprocedure (low-dose CT P = 0.014, CT/CT fluoroscopyP = 0.004), but no difference between groups at 1 day (P = 0.196), 1 week (P = 0.368), or 1 month(P = 0.514).CONCLUSIONSacral and supra-acetabular cementoplasties can be performed safely and precisely using lowdose multiple-acquisition CT guidance while providing significant radiation dose reduction withno difference in extravasation rates, postprocedural pain reduction, and complications compared with CT/CT fluoroscopy.
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- 1. Dasgupta B, Shah N, Brown H, Gordon TE, Tanqueray AB, Mellor JA. Sacral insufficiency fractures: an unsuspected cause of low back pain. Br J Rheumatol 1998; 37:789–793. [CrossRef]
- 2. Thomas EN, Cyteval C, Herisson C, Leonard L, Blotman F. Osteoporotic fracture of the sacrum: sacroplasty and physical medecine. Ann Phys Rehabil Med 2009; 52:427–435. [CrossRef]
- 3. Wallace AN, Tomasian A, Vaswani D, Vyhmeister R, Chang RO, Jennings JW. Radiographic local control of spinal metastases with percutaneous radiofrequency ablation and vertebral augmentation. AJNR Am J Neuroradiol 2016; 37:759–765. [CrossRef]
- 4. Garant M. Sacroplasty: a new treatment for sacral insufficiency fracture. J Vasc Interv Radiol 2002; 13:1265–1267. [CrossRef]
- 5. Butler CL, Given CA, 2nd, Michel SJ, Tibbs PA. Percutaneous sacroplasty for the treatment of sacral insufficiency fractures. AJR Am J Roentgenol 2005; 184:1956–1959. [CrossRef]
- 6. Kortman K, Ortiz O, Miller T, et al. Multicenter study to assess the efficacy and safety of sacroplasty in patients with osteoporotic sacral insufficiency fractures or pathologic sacral lesions. J Neurointerv Surg 2013; 5:461–466. [CrossRef]
- 7. Frey ME, DePalma MJ, Cifu DX, Bhagia SM, Daitch JS. Efficacy and safety of percutaneous sacroplasty for painful osteoporotic sacral insufficiency fractures: a prospective, multicenter trial. Spine (Phila Pa 1976) 2007; 32:1635–1640. [CrossRef]
- 8. Kamel EM, Binaghi S, Guntern D, Mouhsine E, Schnyder P, Theumann N. Outcome of long-axis percutaneous sacroplasty for the treatment of sacral insufficiency fractures. Eur Radiol 2009; 19:3002–3007. [CrossRef]
- 9. Katsanos K, Sabharwal T, Adam A. Percutaneous cementoplasty. Semin Intervent Radiol 2010; 27:137–147. [CrossRef]
- 10. Gupta AC, Yoo AJ, Stone J, et al. Percutaneous sacroplasty. J Neurointerv Surg 2012; 4:385– 389. [CrossRef]
- 11. Cannavale A, Salvatori FM, Wlderk A, Cirelli C, d'Adamo A, Fanelli F. Percutaneous vertebroplasty with the rotational fluoroscopy imaging technique. Skeletal Radiol 2014; 43:1529–1536. [CrossRef]
- 12. Nawfel RD, Judy PF, Silverman SG, Hooton S, Tuncali K, Adams DF. Patient and personnel exposure during CT fluoroscopy-guided interventional procedures. Radiology 2000; 216:180–184. [CrossRef]
- 13. Silverman SG, Tuncali K, Adams DF, Nawfel RD, Zou KH, Judy PF. CT fluoroscopy-guided abdominal interventions: techniques, results, and radiation exposure. Radiology 1999; 212:673– 681. [CrossRef]
- 14. Kang SE, Lee JW, Kim JH, Park KW, Yeom JS, Kang HS. Percutaneous sacroplasty with the use of C-arm flat-panel detector CT: technical feasibility and clinical outcome. Skeletal Radiol 2011; 40:453–460. [CrossRef]
- 15. Bandela JR, Jacob RP, Arreola M, Griglock TM, Bova F, Yang M. Use of CT-based intraoperative spinal navigation: management of radiation exposure to operator, staff, and patients. World Neurosurg 2013; 79:390–394. [CrossRef]
- 16. Tabaraee E, Gibson AG, Karahalios DG, Potts EA, Mobasser JP, Burch S. Intraoperative cone beam-computed tomography with navigation (O-ARM) versus conventional fluoroscopy (C-ARM): a cadaveric study comparing accuracy, efficiency, and safety for spinal instrumentation. Spine (Phila Pa 1976) 2013; 38:1953– 1958. [CrossRef]
- 17. Shrimpton PC HM, Lewis MA, Dunn M Doses from computed tomography (CT) examinations in the UK-2003 review. Chilton, UK: National Radiological Protection Board; 2005.
- 18. Gangi A, Kastler BA, Dietemann JL. Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy. AJNR Am J Neuroradiol 1994; 15:83–86.
- 19. Prosch H, Stadler A, Schilling M, et al. CT fluoroscopy-guided vs. multislice CT biopsy mode-guided lung biopsies: accuracy, complications and radiation dose. Eur J Radiol 2012; 81:1029–1033. [CrossRef]
- 20. Paulson EK, Sheafor DH, Enterline DS, McAdams HP, Yoshizumi TT. CT fluoroscopy--guided interventional procedures: techniques and radiation dose to radiologists. Radiology 2001; 220:161–167. [CrossRef]
- 21. Lamba R. Radiation dose optimization for CT-guided interventional procedures in the abdomen and pelvis. J Am Coll Radiol 2014; 11:279–284. [CrossRef]
- 22. Carlson SK, Bender CE, Classic KL, et al. Benefits and safety of CT fluoroscopy in interventional radiologic procedures. Radiology 2001; 219:515–520. [CrossRef]
- 23. Kloeckner R, dos Santos DP, Schneider J, Kara L, Dueber C, Pitton MB. Radiation exposure in CT-guided interventions. Eur J Radiol 2013; 82:2253–2257. [CrossRef]
- 24. Paik NC. Radiation dose reduction in CT fluoroscopy-guided cervical transforaminal epidural steroid injection by modifying scout and planning steps. Cardiovasc Intervent Radiol 2016; 39:591–599. [CrossRef]
- 25. Paik NC. Radiation dose reduction in CT fluoroscopy-guided lumbar interlaminar epidural steroid injection by minimizing preliminary planning imaging. Eur Radiol 2014; 24:2109– 2117. [CrossRef]
- 26. Sarti M, Brehmer WP, Gay SB. Low-dose techniques in CT-guided interventions. Radiographics 2012; 32:1109–1120. [CrossRef]
- 27. Shepherd TM, Hess CP, Chin CT, Gould R, Dillon WP. Reducing patient radiation dose during CT-guided procedures: demonstration in spinal injections for pain. AJNR Am J Neuroradiol 2011; 32:1776–1782. [CrossRef]
- 28. Artner J, Cakir B, Weckbach S, Reichel H, Lattig F. Radiation dose reduction in CT-guided periradicular injections in lumbar spine: Feasibility of a new institutional protocol for improved patient safety. Patient Saf Surg 2012; 6:19. [CrossRef]
- 29. Artner J, Lattig F, Reichel H, Cakir B. Effective radiation dose reduction in computed tomography-guided spinal injections: a prospective, comparative study with technical considerations. Orthop Rev (Pavia) 2012; 4:e24. [CrossRef]
- 30. Boos J, Lanzman RS, Meineke A, et al. Dose monitoring using the DICOM structured report: assessment of the relationship between cumulative radiation exposure and BMI in abdominal CT. Clin Radiol 2015; 70:176–182. [CrossRef]
- 31. Gupta AC, Chandra RV, Yoo AJ, et al. Safety and effectiveness of sacroplasty: a large single-center experience. AJNR Am J Neuroradiol 2014; 35:2202–2206. [CrossRef]
- 32. Moussazadeh N, Laufer I, Werner T, et al. Sacroplasty for cancer-associated insufficiency fractures. Neurosurgery 2015; 76:446–450. [CrossRef]
- 33. Frey ME, Warner C, Thomas SM, et al. Sacroplasty: a ten-year analysis of prospective patients treated with percutaneous sacroplasty: literature review and technical considerations. Pain Physician 2017; 20:E1063–1072.
- 34. Bayley E, Srinivas S, Boszczyk BM. Clinical outcomes of sacroplasty in sacral insufficiency fractures: a review of the literature. Eur Spine J 2009; 18:1266–1271. [CrossRef]
| APA | Shah V, Hillen T, Jennings J (2019). Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty. , 353 - 359. 10.5152/dir.2019.18362 |
| Chicago | Shah Veer,Hillen Travis,Jennings Jack Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty. (2019): 353 - 359. 10.5152/dir.2019.18362 |
| MLA | Shah Veer,Hillen Travis,Jennings Jack Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty. , 2019, ss.353 - 359. 10.5152/dir.2019.18362 |
| AMA | Shah V,Hillen T,Jennings J Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty. . 2019; 353 - 359. 10.5152/dir.2019.18362 |
| Vancouver | Shah V,Hillen T,Jennings J Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty. . 2019; 353 - 359. 10.5152/dir.2019.18362 |
| IEEE | Shah V,Hillen T,Jennings J "Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty." , ss.353 - 359, 2019. 10.5152/dir.2019.18362 |
| ISNAD | Shah, Veer vd. "Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty". (2019), 353-359. https://doi.org/10.5152/dir.2019.18362 |
| APA | Shah V, Hillen T, Jennings J (2019). Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty. Diagnostic and Interventional Radiology, 25(5), 353 - 359. 10.5152/dir.2019.18362 |
| Chicago | Shah Veer,Hillen Travis,Jennings Jack Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty. Diagnostic and Interventional Radiology 25, no.5 (2019): 353 - 359. 10.5152/dir.2019.18362 |
| MLA | Shah Veer,Hillen Travis,Jennings Jack Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty. Diagnostic and Interventional Radiology, vol.25, no.5, 2019, ss.353 - 359. 10.5152/dir.2019.18362 |
| AMA | Shah V,Hillen T,Jennings J Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty. Diagnostic and Interventional Radiology. 2019; 25(5): 353 - 359. 10.5152/dir.2019.18362 |
| Vancouver | Shah V,Hillen T,Jennings J Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty. Diagnostic and Interventional Radiology. 2019; 25(5): 353 - 359. 10.5152/dir.2019.18362 |
| IEEE | Shah V,Hillen T,Jennings J "Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty." Diagnostic and Interventional Radiology, 25, ss.353 - 359, 2019. 10.5152/dir.2019.18362 |
| ISNAD | Shah, Veer vd. "Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty". Diagnostic and Interventional Radiology 25/5 (2019), 353-359. https://doi.org/10.5152/dir.2019.18362 |
