Öz
Kaynakça
- 1. Manjunatha N, Ganduri V, Rajasekaran K, Duraiyarasan S, Adefuye M. Transarterial Chemoembolization and Unresectable Hepatocellular Carcinoma: A Narrative Review. Cureus. 2022;14(8):e28439. doi: 10.7759/cureus.28439.
- 2. Du N, Yang MJ, Ma JQ, et al. Transradial access chemoembolization for hepatocellular carcinoma in comparation with transfemoral access. Transl Cancer Res. 2019;8(5):1795-1805. doi: 10.21037/tcr.2019.08.40.
- 3. Ali S, Abdullah MS, Abdelrahman K, Ali A, Faisal F, Ali A. Total Radial Artery Occlusion Following Transradial Access: Complete Recanalization via the Anatomical Snuffbox. Methodist Debakey Cardiovasc J. 2020;16(4):314-317. doi: 10.14797/mdcj-16-4-314.
- 4. Brown AM, Kassab I, Massani M, et al. TACE versus TARE for patients with hepatocellular carcinoma: Overall and individual patient level meta analysis. Cancer Med. 2023;12(3):2590-2599. doi: 10.1002/cam4.5125.
- 5. Reincke M, Schultheiss M, Doppler M, et al. Hepatic decompensation after transarterial radioembolization: A retrospective analysis of risk factors and outcome in patients with hepatocellular carcinoma. Hepatol Commun. 2022;6(11):3223-3233. doi: 10.1002/hep4.2072.
- 6. Mikell JK, Dewaraja YK, Owen D. Transarterial Radioembolization for Hepatocellular Carcinoma and Hepatic Metastases: Clinical Aspects and Dosimetry Models. Semin Radiat Oncol. 2020;30(1):68-76. doi: 10.1016/j.semradonc.2019.08.005.
- 7. Biederman DM, Marinelli B, O'Connor PJ, et al. Transradial access for visceral endovascular interventions in morbidly obese patients: safety and feasibility. J Vasc Access. 2016;17(3):256-260. doi: 10.5301/jva.5000530.
- 8. Salem R, Lewandowski RJ, Kulik L, et al. Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology. 2011;140(2):497-507.e2. doi: 10.1053/j.gastro.2010.10.049.
- 9. Kooby DA, Egnatashvili V, Srinivasan S, et al. Comparison of yttrium-90 radioembolization and transcatheter arterial chemoembolization for the treatment of unresectable hepatocellular carcinoma. J Vasc Interv Radiol. 2010;21(2):224-230. doi: 10.1016/j.jvir.2009.10.013.
- 10. Loewenstern J, Welch C, Lekperic S, et al. Patient Radiation Exposure in Transradial versus Transfemoral Yttrium-90 Radioembolization: A Retrospective Propensity Score-Matched Analysis. J Vasc Interv Radiol. 2018;29(7):936-942. doi: 10.1016/j.jvir.2018.02.011.
- 11. Pedersoli F, Fang J, Boas E, Park JJ. Operator radiation exposure during radioembolisation of the liver: transfemoral versus transradial access using real-time dose monitoring. Radiat Prot Dosimetry. 2023;199(19):2344-2348. doi: 10.1093/rpd/ncad236.
- 12. Jiang H, Chen Y, Liao H, Gu Y, Meng X, Dong W. Operator radiation dose during trans-hepatic arterial chemoembolization: different patients' positions via transradial or transfemoral access. Diagn Interv Radiol. 2022;28(4):376-382. doi: 10.5152/dir.2022.211327.
- 13. Sciahbasi A, Rigattieri S, Sarandrea A, et al. Determinants of operator radiation exposure during percutaneous coronary procedures. Am Heart J. 2017;187:10-18. doi: 10.1016/j.ahj.2017.02.012.
- 14. Yamada R, Bracewell S, Bassaco B, et al. Transradial Versus Transfemoral Arterial Access in Liver Cancer Embolization: Randomized Trial to Assess Patient Satisfaction. J Vasc Interv Radiol. 2018;29(1):38-43. doi: 10.1016/j.jvir.2017.08.024.
- 15. Ghosh A, Gupta V, Al Khalifah A, Akhter NM. Transradial versus transfemoral arterial access in DEB-TACE for hepatocellular carcinoma. J Clin Imaging Sci. 2022;12:38. doi: 10.25259/JCIS_47_2022.
- 16. Khayrutdinov ER, Рафаилович ХЕ, Gromov DG, Геннадьевич ГД, Arablinskiy AV, Владимирович АА. The comparative analysis of transradial and transfemoral vascular approaches for chemoembolization of pancreatic cancer. Russian J Oncol. 2021;26(5):155-162.
- 17. Jolly SS, Cairns J, Niemela K, et al; RIVAL Investigators. Effect of radial versus femoral access on radiation dose and the importance of procedural volume: a substudy of the multicenter randomized RIVAL trial. JACC Cardiovasc Interv. 2013;6(3):258-266. doi: 10.1016/j.jcin.2012.10.016.
- 18. Sciahbasi A, Frigoli E, Sarandrea A, et al. Radiation Exposure and Vascular Access in Acute Coronary Syndromes: The RAD-Matrix Trial. J Am Coll Cardiol. 2017;69(20):2530-2537. doi: 10.1016/j.jacc.2017.03.018.
Radiation dose comparison of transradial and transfemoral access in transarterial radioembolization and chemoembolization
Öz
Objective: To compare radiation doses associated with transradial access (TRA) and transfemoral access (TFA) in transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) procedures for hepatic cancers.
Methods: This retrospective, single-center study analyzed 119 patients who underwent TACE or TARE between October 2016 and October 2024. Radiation dose parameters were compared between TRA and TFA groups, including fluoroscopy time, fluoroscopy and fluoroscopy-digital radiography combined dose-area product (DAP), and total air kerma (AK). Statistical analyses were performed using the Mann-Whitney U test and Chi-squared test.
Results: TRA was associated with significantly higher radiation exposure compared to TFA, including increased fluoroscopy time (median: 15.2 vs. 8.9 minutes, P<0.001), fluoroscopy DAP (median: 84.4 vs. 45.2 Gy∙cm², P<0.001), fluoroscopy-digital radiography combined DAP (median: 246 vs. 156.5 Gy∙cm², P=0.003), and AK (median: 959 vs. 612.9 mGy, P=0.001). No significant differences were observed in patient demographics, tumor localization, or treatment approach between the groups.
Conclusions: TRA is associated with higher radiation exposure compared to TFA in TACE and TARE procedures. While TRA offers procedural benefits, further research is needed to optimize techniques and reduce radiation risks, particularly in interventional radiology.
Anahtar Kelimeler
Transarterial radioembolization transarterial chemoembolization transfemoral access transradial access radiation dose
Etik Beyan
All procedures conducted in studies involving human participants complied with the ethical standards of the institutional and/or national research committee, as well as the 1964 Helsinki Declaration and its subsequent amendments or equivalent ethical guidelines. The local ethics committee (Acibadem Mehmet Ali Aydinlar University) approved this retrospective study and waived the requirement for informed consent for the retrospective analysis of anonymized medical data (Decision number: 2024-14/576 and date: 19.09.2024).
Kaynakça
- 1. Manjunatha N, Ganduri V, Rajasekaran K, Duraiyarasan S, Adefuye M. Transarterial Chemoembolization and Unresectable Hepatocellular Carcinoma: A Narrative Review. Cureus. 2022;14(8):e28439. doi: 10.7759/cureus.28439.
- 2. Du N, Yang MJ, Ma JQ, et al. Transradial access chemoembolization for hepatocellular carcinoma in comparation with transfemoral access. Transl Cancer Res. 2019;8(5):1795-1805. doi: 10.21037/tcr.2019.08.40.
- 3. Ali S, Abdullah MS, Abdelrahman K, Ali A, Faisal F, Ali A. Total Radial Artery Occlusion Following Transradial Access: Complete Recanalization via the Anatomical Snuffbox. Methodist Debakey Cardiovasc J. 2020;16(4):314-317. doi: 10.14797/mdcj-16-4-314.
- 4. Brown AM, Kassab I, Massani M, et al. TACE versus TARE for patients with hepatocellular carcinoma: Overall and individual patient level meta analysis. Cancer Med. 2023;12(3):2590-2599. doi: 10.1002/cam4.5125.
- 5. Reincke M, Schultheiss M, Doppler M, et al. Hepatic decompensation after transarterial radioembolization: A retrospective analysis of risk factors and outcome in patients with hepatocellular carcinoma. Hepatol Commun. 2022;6(11):3223-3233. doi: 10.1002/hep4.2072.
- 6. Mikell JK, Dewaraja YK, Owen D. Transarterial Radioembolization for Hepatocellular Carcinoma and Hepatic Metastases: Clinical Aspects and Dosimetry Models. Semin Radiat Oncol. 2020;30(1):68-76. doi: 10.1016/j.semradonc.2019.08.005.
- 7. Biederman DM, Marinelli B, O'Connor PJ, et al. Transradial access for visceral endovascular interventions in morbidly obese patients: safety and feasibility. J Vasc Access. 2016;17(3):256-260. doi: 10.5301/jva.5000530.
- 8. Salem R, Lewandowski RJ, Kulik L, et al. Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology. 2011;140(2):497-507.e2. doi: 10.1053/j.gastro.2010.10.049.
- 9. Kooby DA, Egnatashvili V, Srinivasan S, et al. Comparison of yttrium-90 radioembolization and transcatheter arterial chemoembolization for the treatment of unresectable hepatocellular carcinoma. J Vasc Interv Radiol. 2010;21(2):224-230. doi: 10.1016/j.jvir.2009.10.013.
- 10. Loewenstern J, Welch C, Lekperic S, et al. Patient Radiation Exposure in Transradial versus Transfemoral Yttrium-90 Radioembolization: A Retrospective Propensity Score-Matched Analysis. J Vasc Interv Radiol. 2018;29(7):936-942. doi: 10.1016/j.jvir.2018.02.011.
- 11. Pedersoli F, Fang J, Boas E, Park JJ. Operator radiation exposure during radioembolisation of the liver: transfemoral versus transradial access using real-time dose monitoring. Radiat Prot Dosimetry. 2023;199(19):2344-2348. doi: 10.1093/rpd/ncad236.
- 12. Jiang H, Chen Y, Liao H, Gu Y, Meng X, Dong W. Operator radiation dose during trans-hepatic arterial chemoembolization: different patients' positions via transradial or transfemoral access. Diagn Interv Radiol. 2022;28(4):376-382. doi: 10.5152/dir.2022.211327.
- 13. Sciahbasi A, Rigattieri S, Sarandrea A, et al. Determinants of operator radiation exposure during percutaneous coronary procedures. Am Heart J. 2017;187:10-18. doi: 10.1016/j.ahj.2017.02.012.
- 14. Yamada R, Bracewell S, Bassaco B, et al. Transradial Versus Transfemoral Arterial Access in Liver Cancer Embolization: Randomized Trial to Assess Patient Satisfaction. J Vasc Interv Radiol. 2018;29(1):38-43. doi: 10.1016/j.jvir.2017.08.024.
- 15. Ghosh A, Gupta V, Al Khalifah A, Akhter NM. Transradial versus transfemoral arterial access in DEB-TACE for hepatocellular carcinoma. J Clin Imaging Sci. 2022;12:38. doi: 10.25259/JCIS_47_2022.
- 16. Khayrutdinov ER, Рафаилович ХЕ, Gromov DG, Геннадьевич ГД, Arablinskiy AV, Владимирович АА. The comparative analysis of transradial and transfemoral vascular approaches for chemoembolization of pancreatic cancer. Russian J Oncol. 2021;26(5):155-162.
- 17. Jolly SS, Cairns J, Niemela K, et al; RIVAL Investigators. Effect of radial versus femoral access on radiation dose and the importance of procedural volume: a substudy of the multicenter randomized RIVAL trial. JACC Cardiovasc Interv. 2013;6(3):258-266. doi: 10.1016/j.jcin.2012.10.016.
- 18. Sciahbasi A, Frigoli E, Sarandrea A, et al. Radiation Exposure and Vascular Access in Acute Coronary Syndromes: The RAD-Matrix Trial. J Am Coll Cardiol. 2017;69(20):2530-2537. doi: 10.1016/j.jacc.2017.03.018.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Radyoloji ve Organ Görüntüleme |
| Bölüm | Original Article |
| Yazarlar | |
| Erken Görünüm Tarihi | 10 Şubat 2025 |
| Yayımlanma Tarihi | 4 Mart 2025 |
| Gönderilme Tarihi | 22 Ocak 2025 |
| Kabul Tarihi | 9 Şubat 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 11 Sayı: 2 |
