Radiography最新文献

Introduction: Cone Beam Computed Tomography (CBCT) is essential in Image-Guided Radiation Therapy (IGRT), enabling more accurate treatments but increasing patients exposure to radiation. Despite advancements in dose reduction acquisition methods, routine daily CBCT imaging can still result in a considerable cumulative radiation dose to the patient, which should be considered and assessed.

Methods: This study aimed at estimating the radiation doses absorbed with MOSFET detectors of some radiosensitive organs (e.g. lung, stomach, liver) during thoracic CBCT examination and calculates the risk of cancer incidence and mortality with adult thorax physical phantom.

Results: The absorbed doses in the aforementioned organs ranged between 3 mGy and 8 mGy per fraction, close to the isocenter. Over 33 fractions, the cumulative absorbed dose reached approximately 260 mGy. The analysis of cancer incidence and mortality risk through BEIR VII model revealed that the lungs have the highest number of cases for each age considered (20-80 years interval). Comparing dose assessment obtained using several methods (Monte Carlo, TLDs and MOSFETs), with the same irradiation protocol, lung dose varies among 2.08 mGy and 7.60 mGy, whereas the heart varies among 4.9 Gy and 10 mGy.

Conclusion: Although surrogate dose-index methods are often used, organ absorbed doses assessment should be the preferred method to assess the magnitude of realistic organ radiation risk of populations undergoing examinations with ionizing radiation.

Implications for practice: Promoting experimental dosimetry phantom studies in a more harmonized way would increase the accuracy of organ absorbed dose assessment and consequently would improve the risk communication and decision-making for better CBCT protocols choice in clinical settings.

Introduction: CT-guided percutaneous lung biopsy remains essential for diagnosing pulmonary nodules but is frequently complicated by pneumothorax, hemorrhage, and hemoptysis. Laser-assisted CT-guided biopsy (LACT) has been proposed to enhance procedural precision and safety. This meta-analysis compared the efficacy and safety of LACT versus conventional CT-guided (CCT) lung biopsies.

Methods: A comprehensive search of six electronic databases was performed to identify studies comparing LACT and CCT lung biopsies. Statistical analyses were performed using RevMan 5.4.1, and P < 0.05 was considered statistically significant. Meta-regression was done by Open Meta-Analyst.

Results: Twelve studies involving 1353 patients were included. The LACT group demonstrated significantly higher first-puncture success (RR = 2.47, 95 % CI: 1.44-4.23, P = 00.001), fewer CT scans and needle adjustments (MD = -1.50, 95 % CI: -2.08 to -0.91, P < 0.00001), shorter procedure duration (MD = -7.69 min, 95 % CI: -9.75 to -5.64, P < 0.00001), and shorter intraoperative time (P < 0.00001). LACT also showed a lower overall complication rate, including pneumothorax, hemorrhage, and hemoptysis. Meta-regression indicated that increasing age was associated with a higher pneumothorax risk.

Conclusions: LACT-guided lung biopsy improves first-puncture success, procedural efficiency, and safety compared with the conventional approach. However, as most studies originated from a single geographic region and had variable methodological quality, these findings require confirmation through larger, multicenter randomized controlled trials.

Implications for practice: LACT may offer procedural and safety advantages over conventional CT-guided lung biopsy, with the potential to reduce risks to patients. Future considerations include the need for robust, generalizable evidence beyond the studied population and geographic setting, along with support for wider clinical implementation such as standardized device specifications, workflow and protocol optimization, professional-body guidance, and operator training.