Radiation dose during transarterial chemoembolization and associated factors

Area of Science:

• Interventional Radiology
• Medical Physics
• Oncology

Background:

• Transarterial chemoembolization (TACE) is a standard treatment for hepatocellular carcinoma (HCC).
• Cone-beam computed tomography (CBCT) is increasingly used during TACE for improved visualization.
• Accurate reporting of radiation doses is crucial for patient safety and procedure optimization.

Purpose of the Study:

• To detail radiation doses administered during TACE procedures in the CBCT era.
• To identify patient and procedural factors associated with increased radiation exposure.

Main Methods:

• Retrospective analysis of 385 HCC patients undergoing initial TACE.
• Inclusion of CBCT for tumor and vascular anatomy assessment.
• Recording of dose area product (DAP) and air kerma (CAK) from fluoroscopy, DSA, and CBCT.
• Multiple linear regression to identify predictors of increased DAP.

Main Results:

• Mean total DAP was 165.2 Gy·cm² and mean total CAK was 837.1 mGy.
• CBCT contributed a significant portion of the overall radiation dose.
• Male sex, higher BMI, larger tumors (>3 cm), aberrant hepatic arteries, and superselective TACE were linked to higher DAP.

Conclusions:

• Detailed radiation dose data for TACE with CBCT are provided.
• Specific patient and procedural characteristics are identified as key factors influencing radiation dose.
• Findings can inform strategies to optimize radiation safety during TACE.