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Radiation dose during transarterial chemoembolization and associated factors

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Abstract

Purpose

To provide detailed reports on radiation doses during transarterial chemoembolization (TACE) in the cone-beam computed tomography (CBCT) era and to identify the associated factors.

Methods

This retrospective study included 385 consecutive patients who underwent initial conventional TACE for hepatocellular carcinoma (HCC) between January 2016 and December 2017. In most cases, CBCT was performed at the common hepatic artery or celiac axis to confirm the location of the tumor and the three-dimensional hepatic artery anatomy. Superselective TACE was performed for all technically feasible cases. Information on total dose area product (DAP), total cumulative air kerma (CAK), fluoroscopy time, and DAP and CAK of each digital subtraction angiography (DSA) and CBCT scan was recorded. Multiple linear regression analysis was performed to identify the factors associated with increased DAP during TACE.

Results

The mean values of total DAP and CAK were 165.2 ± 81.2 (Gy·cm²) and 837.1 ± 571.0 (mGy), respectively. The mean fluoroscopy time was 19.1 ± 10.3 min. The mean DAP caused by fluoroscopy, DSA, and CBCT was 51.8 ± 43.9, 28.0 ± 24.1, and 83.9 ± 42.1 Gy·cm², respectively. Male sex, a high body mass index, largest tumor size > 3 cm, presence of aberrant right and left hepatic arteries, and superselective TACE were identified as independent predictors of increased total DAP during TACE.

Conclusion

We were able to provide detailed reports on radiation doses during TACE and associated factors.

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Data availability

The authors will share the date upon reasonable request to the corresponding author.

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Acknowledgements

This work has been posted as a preprint as follows. Author names: Tae Won Choi, ** Wook Chung. Title: Radiation Dose During Transarterial Chemoembolization and Risk Factors for High Radiation Dose. Name of the preprint server: https://www.researchsquare.com/article/rs-3190102/v1. Object type: Preprint. Date of most recent version posted: 18 Aug, 2023. Date accessed: 21 Nov, 2023. DOI: https://doi.org/10.21203/rs.3.rs-3190102/v1.

Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, Ajou University School of Medicine, Suwon, Korea

    Tae Won Choi

  2. Department of Radiology, Seoul National University Hospital, Seoul, Korea

    ** Wook Chung

  3. Department of Radiology, Seoul National University College of Medicine, Seoul, Korea

    ** Wook Chung

  4. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea

    ** Wook Chung

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Contributions

Conceptualization: Tae Won Choi, ** Wook Chung. Data curation: Tae Won Choi, ** Wook Chung. Formal analysis: Tae Won Choi, ** Wook Chung. Investigation: Tae Won Choi, ** Wook Chung. Methodology: Tae Won Choi, ** Wook Chung. Supervision: ** Wook Chung. Writing-original draft: Tae Won Choi. Writing-review and editing: Tae Won Choi, ** Wook Chung.

Corresponding author

Correspondence to ** Wook Chung.

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The authors have no relevant financial or non-financial interests to disclose.

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The institutional review board of Seoul National University Hospital approved the present study and waived the requirement for informed consent because of its retrospective design. This study was conducted according to the Declaration of Helsinki and the International Conference on Harmonization Good Clinical Practices.

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Choi, T.W., Chung, J.W. Radiation dose during transarterial chemoembolization and associated factors. Abdom Radiol (2024). https://doi.org/10.1007/s00261-024-04370-0

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