Omission of Planning CT Reduces Patient Radiation Exposure during CT-Guided Bone Marrow Biopsy and Aspiration

The purpose of this study is to evaluate the impact of eliminating a preprocedural planning computed tomography during CT-guided bone marrow biopsy on the technical aspects of the procedure, including patient dose, sample quality, procedure time, and CT fluoroscopy usage. Retrospective analysis of 1...

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Main Authors: Robert Devita, Kaushik Chagarlamudi, Jared Durieux, David Jordan, Brian Nguyen, Jon Davidson, Vijaya Kosaraju, Salim Abboud
Format: Article
Language:English
Published: MDPI AG 2021-11-01
Series:Tomography
Subjects:
Online Access:https://www.mdpi.com/2379-139X/7/4/62
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author Robert Devita
Kaushik Chagarlamudi
Jared Durieux
David Jordan
Brian Nguyen
Jon Davidson
Vijaya Kosaraju
Salim Abboud
author_facet Robert Devita
Kaushik Chagarlamudi
Jared Durieux
David Jordan
Brian Nguyen
Jon Davidson
Vijaya Kosaraju
Salim Abboud
author_sort Robert Devita
collection DOAJ
description The purpose of this study is to evaluate the impact of eliminating a preprocedural planning computed tomography during CT-guided bone marrow biopsy on the technical aspects of the procedure, including patient dose, sample quality, procedure time, and CT fluoroscopy usage. Retrospective analysis of 109 patients between 1 June 2018 and 1 January 2021 was performed. Patients were grouped based on whether they received a planning CT scan. Relative radiation exposure was measured using dose-length product (DLP). Secondary metrics included number of CT fluoroscopic acquisitions until target localization, total number of CT fluoroscopic acquisitions, biopsy diagnostic yield, and procedure time. A total of 43 bone marrow biopsies with planning CT scans (Group 1) and 66 bone marrow biopsies without planning CT scans (Group 2) were performed. The average total DLP for Group 1 and Group 2 was 268.73 mGy*cm and 50.92 mGy*cm, respectively. The mean radiation dose reduction between the groups was 81% (<i>p</i> < 0.0001). Significantly more CT fluoroscopy acquisitions were needed for needle localization in Group 2 than Group 1 (<i>p</i> < 0.0001). Total number of CT fluoroscopy acquisitions was four for Group 1 and eight for Group 2 (<i>p</i> = 0.0002). There was no significant difference between the groups in procedure time or diagnostic yield. Patients without a planning CT scan received more fluoroscopic CT acquisitions but overall were exposed to significantly less radiation without an increase in procedure time.
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spelling doaj.art-6119cbe06859429c9885f6d811ef92512023-11-23T10:49:11ZengMDPI AGTomography2379-13812379-139X2021-11-017474775110.3390/tomography7040062Omission of Planning CT Reduces Patient Radiation Exposure during CT-Guided Bone Marrow Biopsy and AspirationRobert Devita0Kaushik Chagarlamudi1Jared Durieux2David Jordan3Brian Nguyen4Jon Davidson5Vijaya Kosaraju6Salim Abboud7University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USAUniversity Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USAUniversity Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USAUniversity Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USASchool of Medicine, Case Western Reserve University, Cleveland, OH 44106, USAUniversity Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USAUniversity Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USAUniversity Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USAThe purpose of this study is to evaluate the impact of eliminating a preprocedural planning computed tomography during CT-guided bone marrow biopsy on the technical aspects of the procedure, including patient dose, sample quality, procedure time, and CT fluoroscopy usage. Retrospective analysis of 109 patients between 1 June 2018 and 1 January 2021 was performed. Patients were grouped based on whether they received a planning CT scan. Relative radiation exposure was measured using dose-length product (DLP). Secondary metrics included number of CT fluoroscopic acquisitions until target localization, total number of CT fluoroscopic acquisitions, biopsy diagnostic yield, and procedure time. A total of 43 bone marrow biopsies with planning CT scans (Group 1) and 66 bone marrow biopsies without planning CT scans (Group 2) were performed. The average total DLP for Group 1 and Group 2 was 268.73 mGy*cm and 50.92 mGy*cm, respectively. The mean radiation dose reduction between the groups was 81% (<i>p</i> < 0.0001). Significantly more CT fluoroscopy acquisitions were needed for needle localization in Group 2 than Group 1 (<i>p</i> < 0.0001). Total number of CT fluoroscopy acquisitions was four for Group 1 and eight for Group 2 (<i>p</i> = 0.0002). There was no significant difference between the groups in procedure time or diagnostic yield. Patients without a planning CT scan received more fluoroscopic CT acquisitions but overall were exposed to significantly less radiation without an increase in procedure time.https://www.mdpi.com/2379-139X/7/4/62radiation exposurequality improvementCT-guided procedures
spellingShingle Robert Devita
Kaushik Chagarlamudi
Jared Durieux
David Jordan
Brian Nguyen
Jon Davidson
Vijaya Kosaraju
Salim Abboud
Omission of Planning CT Reduces Patient Radiation Exposure during CT-Guided Bone Marrow Biopsy and Aspiration
Tomography
radiation exposure
quality improvement
CT-guided procedures
title Omission of Planning CT Reduces Patient Radiation Exposure during CT-Guided Bone Marrow Biopsy and Aspiration
title_full Omission of Planning CT Reduces Patient Radiation Exposure during CT-Guided Bone Marrow Biopsy and Aspiration
title_fullStr Omission of Planning CT Reduces Patient Radiation Exposure during CT-Guided Bone Marrow Biopsy and Aspiration
title_full_unstemmed Omission of Planning CT Reduces Patient Radiation Exposure during CT-Guided Bone Marrow Biopsy and Aspiration
title_short Omission of Planning CT Reduces Patient Radiation Exposure during CT-Guided Bone Marrow Biopsy and Aspiration
title_sort omission of planning ct reduces patient radiation exposure during ct guided bone marrow biopsy and aspiration
topic radiation exposure
quality improvement
CT-guided procedures
url https://www.mdpi.com/2379-139X/7/4/62
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