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Background: Computed-tomography-guided interventions are attractive for tissue sampling of paediatric tumor lesions; however, it comes with exposure to ionizing radiation. The aim of this study was to analyse the radiation dose, accuracy and speed of CT-guided interventions in paediatric patient cohort.
Methods: We retrospectively reviewed CT-guided interventions over a 10 -year period in 65 children. The intervention site consisted of bones in 38, chest (lung) in 15 and abdomen (liver, lymph nodes) in 12 cases. Radiation dose and duration of the procedures were analysed. The statistical analysis was performed using dedicated statistical software (BiAS 8.3.6 software, Epsilon Verlag, North Hasted).
Results: All interventions were performed successfully. Mean target access path to lesion within the patients was 6.0 cm (min 3.5 cm, max 11.2 cm). Time duration to complete intervention was 25:15 min (min 17:03 min, max 43:00 min). The dose-length product (DLP) of intervention scan was 29.5 mGy · cm (min 6 mGy · cm, max 85 mGy · cm) with the lowest dose for biopsies in the region of the chest (p = 0.04).
Conclusions: With justified indications, CT-guided paediatric interventions are safe, effective and can be performed both, with short intervention times and low radiation exposure.
Background: To evaluate survival data and local tumor control after transarterial chemoembolization in two groups with different embolization protocols for the treatment of HCC patients.
Methods: Ninty-nine patients (mean age: 63.6 years), 78 male (78.8%) with HCC were repeatedly treated with chemoembolization in 4-week-intervals. Eighty-eight patients had BCLC-Stage-B and in 11 patients, chemoembolization was performed for bridging (BCLC-Stage-A). In total, 667 chemoembolization treatments were performed (mean 6.7 treatments/patient). The administered chemotherapeutic agent included mitomycin. For embolization, lipiodol only (n = 51;51.5%; mean age 63.8 years; 38 male), or lipiodol plus degradable starch microspheres (DSM) (n = 48; 48.5%; mean age 63.4 years; 40 male) were used. The local tumor response was assessed by MRI using Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1). Patient survival times were evaluated using Kaplan-Meier curves and log-rank tests.
Results: The local tumor control in the lipiodol-group was: PR (partial response) in 11 (21.6%), SD (stable disease) in 32 (62.7%) and PD (progressive disease) in 8 cases (15.7%). In the lipiodol-DSM-group, PR was seen in 14 (29.2%), SD in 22 (45.8%), and PD in 12 (25.0%) individuals (p = 0.211). The median survival of patients after chemoembolization with lipiodol was 25 months and in the lipiodol-DSM-group 28 months (p = 0.845).
Conclusion: Our data suggest a slight benefit of the use of lipiodol and DSM in comparison of using lipiodol only for chemoembolization of HCC in terms of local tumor control and survival data, this trend did not reach the level of significance.