Radiation Dose and Risk Estimates of CT-Guided Percutaneous Liver Ablations and Factors Associated with Dose Reduction
Purpose To determine the radiation dose associated with CT-guided percutaneous liver ablations and identify potential risk factors that result in higher radiation doses. Materials and Methods Between June 2011 and June 2015, 245 consecutive patients underwent 304 CT-guided liver ablation treatments....
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| Veröffentlicht in: | Cardiovascular and interventional radiology 2018-12, Vol.41 (12), p.1935-1942 |
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| container_title | Cardiovascular and interventional radiology |
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| creator | McCarthy, Colin J. Kilcoyne, Aoife Li, Xinhua Cahalane, Alexis M. Liu, Bob Arellano, Ronald S. Uppot, Raul N. Gee, Michael S. |
| description | Purpose
To determine the radiation dose associated with CT-guided percutaneous liver ablations and identify potential risk factors that result in higher radiation doses.
Materials and Methods
Between June 2011 and June 2015, 245 consecutive patients underwent 304 CT-guided liver ablation treatments. Patient demographics, tumor characteristics and procedural parameters were identified and analyzed. The peak skin dose and effective dose were assessed for each procedure. Excess relative risk related to radiation effects was calculated. A logistic regression model was prepared by means of stepwise logistic regression to identify variables predictive of increased radiation exposure.
Results
Tumor ablations were performed with microwave (
n
= 220), radiofrequency (
n
= 74) or irreversible electroporation (IRE) (
n
= 10). The mean peak skin dose for ablations was 239.2 ± 136.4 mGy, and the mean effective dose was 36.6 ± 22.3 mSv. Of the patient and procedural parameters that were analyzed, increasing weight, use of intravenous contrast and/or hydrodissection during the procedure, together with treatment of multiple lesions in the same sitting were all associated with higher radiation exposure. The mean increase in the absolute risk of fatal malignancy from a single procedure was 0.18% (range 0.02–0.9%). No deterministic skin changes were identified in the patient cohort.
Conclusion
The overall risk of stochastic and deterministic effects from radiation associated with CT-guided ablations is low compared with other inherent procedural complications. This study identifies several factors that are associated with higher radiation dose in percutaneous liver ablation procedures. |
| doi_str_mv | 10.1007/s00270-018-2066-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_22749691</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2091820701</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-138a813d3ec3fd07cfab2a6385bfc31a64e483cc034d00d76754c2aaf44ffb343</originalsourceid><addsrcrecordid>eNp1kU1v1DAURS0EokPhB7BBltiwMTx_JPEsR0NbkEYCjYrEznJsh7rMxMXPKeLf4zSlXbHywuce6_oS8prDew7QfUAA0QEDrpmAtmX8CVlxJQUD3X5_SlbAO8V40_AT8gLxGoA3WjTPyYkELkVVrMjt3vpoS0wj_ZgwUDt6uo_4k55hiUdbAtI00O0lu5iiD55-DdlNxY4hTUh38TZkuukPdwK8C59bV1JGukFMrppr5ncsV4t9H_zkZvYleTbYA4ZX9-cp-XZ-drn9xHZfLj5vNzvmFEBhXGqrufQyODl46Nxge2FbqZt-cJLbVgWlpXMglQfwXds1yglrB6WGoZdKnpK3izfVOgZdLMFduTSOwRUjRKfW7ZpX6t1C3eT0awpYzDGiC4fD0tMIWHMtoAP-KHxAr9OUx9phpmZOi5niC-VyQsxhMDe5_mb-YziYeTqzTGfqdGaezsyZN_fmqT8G_5D4t1UFxAJgvRp_hPz49P-tfwF4SaLV</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2090918821</pqid></control><display><type>article</type><title>Radiation Dose and Risk Estimates of CT-Guided Percutaneous Liver Ablations and Factors Associated with Dose Reduction</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>McCarthy, Colin J. ; Kilcoyne, Aoife ; Li, Xinhua ; Cahalane, Alexis M. ; Liu, Bob ; Arellano, Ronald S. ; Uppot, Raul N. ; Gee, Michael S.</creator><creatorcontrib>McCarthy, Colin J. ; Kilcoyne, Aoife ; Li, Xinhua ; Cahalane, Alexis M. ; Liu, Bob ; Arellano, Ronald S. ; Uppot, Raul N. ; Gee, Michael S.</creatorcontrib><description>Purpose
To determine the radiation dose associated with CT-guided percutaneous liver ablations and identify potential risk factors that result in higher radiation doses.
Materials and Methods
Between June 2011 and June 2015, 245 consecutive patients underwent 304 CT-guided liver ablation treatments. Patient demographics, tumor characteristics and procedural parameters were identified and analyzed. The peak skin dose and effective dose were assessed for each procedure. Excess relative risk related to radiation effects was calculated. A logistic regression model was prepared by means of stepwise logistic regression to identify variables predictive of increased radiation exposure.
Results
Tumor ablations were performed with microwave (
n
= 220), radiofrequency (
n
= 74) or irreversible electroporation (IRE) (
n
= 10). The mean peak skin dose for ablations was 239.2 ± 136.4 mGy, and the mean effective dose was 36.6 ± 22.3 mSv. Of the patient and procedural parameters that were analyzed, increasing weight, use of intravenous contrast and/or hydrodissection during the procedure, together with treatment of multiple lesions in the same sitting were all associated with higher radiation exposure. The mean increase in the absolute risk of fatal malignancy from a single procedure was 0.18% (range 0.02–0.9%). No deterministic skin changes were identified in the patient cohort.
Conclusion
The overall risk of stochastic and deterministic effects from radiation associated with CT-guided ablations is low compared with other inherent procedural complications. This study identifies several factors that are associated with higher radiation dose in percutaneous liver ablation procedures.</description><identifier>ISSN: 0174-1551</identifier><identifier>EISSN: 1432-086X</identifier><identifier>DOI: 10.1007/s00270-018-2066-1</identifier><identifier>PMID: 30132100</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>ABLATION ; Ablation Techniques - methods ; Aged ; Cardiology ; Clinical Investigation ; Clinical Protocols ; Complications ; CT-GUIDED RADIOTHERAPY ; Demographics ; Demography ; EFFECTIVE RADIATION DOSES ; Electroporation ; Exposure ; Female ; Health risk assessment ; Humans ; Imaging ; Intravenous administration ; Lesions ; LIVER ; Liver cancer ; Liver Neoplasms - surgery ; Male ; Malignancy ; Medicine ; Medicine & Public Health ; Middle Aged ; NEOPLASMS ; Nuclear Medicine ; PATIENTS ; Radiation Dosage ; Radiation effects ; Radiation Exposure - statistics & numerical data ; RADIATION HAZARDS ; Radiation Protection ; Radio frequency ; Radiography, Interventional - methods ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; Retrospective Studies ; Risk analysis ; Risk Assessment - methods ; Risk factors ; Skin ; Tomography, X-Ray Computed - methods ; Tumors ; Ultrasound ; Weight</subject><ispartof>Cardiovascular and interventional radiology, 2018-12, Vol.41 (12), p.1935-1942</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018</rights><rights>CardioVascular and Interventional Radiology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-138a813d3ec3fd07cfab2a6385bfc31a64e483cc034d00d76754c2aaf44ffb343</citedby><cites>FETCH-LOGICAL-c400t-138a813d3ec3fd07cfab2a6385bfc31a64e483cc034d00d76754c2aaf44ffb343</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00270-018-2066-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00270-018-2066-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30132100$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22749691$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>McCarthy, Colin J.</creatorcontrib><creatorcontrib>Kilcoyne, Aoife</creatorcontrib><creatorcontrib>Li, Xinhua</creatorcontrib><creatorcontrib>Cahalane, Alexis M.</creatorcontrib><creatorcontrib>Liu, Bob</creatorcontrib><creatorcontrib>Arellano, Ronald S.</creatorcontrib><creatorcontrib>Uppot, Raul N.</creatorcontrib><creatorcontrib>Gee, Michael S.</creatorcontrib><title>Radiation Dose and Risk Estimates of CT-Guided Percutaneous Liver Ablations and Factors Associated with Dose Reduction</title><title>Cardiovascular and interventional radiology</title><addtitle>Cardiovasc Intervent Radiol</addtitle><addtitle>Cardiovasc Intervent Radiol</addtitle><description>Purpose
To determine the radiation dose associated with CT-guided percutaneous liver ablations and identify potential risk factors that result in higher radiation doses.
Materials and Methods
Between June 2011 and June 2015, 245 consecutive patients underwent 304 CT-guided liver ablation treatments. Patient demographics, tumor characteristics and procedural parameters were identified and analyzed. The peak skin dose and effective dose were assessed for each procedure. Excess relative risk related to radiation effects was calculated. A logistic regression model was prepared by means of stepwise logistic regression to identify variables predictive of increased radiation exposure.
Results
Tumor ablations were performed with microwave (
n
= 220), radiofrequency (
n
= 74) or irreversible electroporation (IRE) (
n
= 10). The mean peak skin dose for ablations was 239.2 ± 136.4 mGy, and the mean effective dose was 36.6 ± 22.3 mSv. Of the patient and procedural parameters that were analyzed, increasing weight, use of intravenous contrast and/or hydrodissection during the procedure, together with treatment of multiple lesions in the same sitting were all associated with higher radiation exposure. The mean increase in the absolute risk of fatal malignancy from a single procedure was 0.18% (range 0.02–0.9%). No deterministic skin changes were identified in the patient cohort.
Conclusion
The overall risk of stochastic and deterministic effects from radiation associated with CT-guided ablations is low compared with other inherent procedural complications. This study identifies several factors that are associated with higher radiation dose in percutaneous liver ablation procedures.</description><subject>ABLATION</subject><subject>Ablation Techniques - methods</subject><subject>Aged</subject><subject>Cardiology</subject><subject>Clinical Investigation</subject><subject>Clinical Protocols</subject><subject>Complications</subject><subject>CT-GUIDED RADIOTHERAPY</subject><subject>Demographics</subject><subject>Demography</subject><subject>EFFECTIVE RADIATION DOSES</subject><subject>Electroporation</subject><subject>Exposure</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Imaging</subject><subject>Intravenous administration</subject><subject>Lesions</subject><subject>LIVER</subject><subject>Liver cancer</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Malignancy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>NEOPLASMS</subject><subject>Nuclear Medicine</subject><subject>PATIENTS</subject><subject>Radiation Dosage</subject><subject>Radiation effects</subject><subject>Radiation Exposure - statistics & numerical data</subject><subject>RADIATION HAZARDS</subject><subject>Radiation Protection</subject><subject>Radio frequency</subject><subject>Radiography, Interventional - methods</subject><subject>Radiology</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk Assessment - methods</subject><subject>Risk factors</subject><subject>Skin</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Tumors</subject><subject>Ultrasound</subject><subject>Weight</subject><issn>0174-1551</issn><issn>1432-086X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1v1DAURS0EokPhB7BBltiwMTx_JPEsR0NbkEYCjYrEznJsh7rMxMXPKeLf4zSlXbHywuce6_oS8prDew7QfUAA0QEDrpmAtmX8CVlxJQUD3X5_SlbAO8V40_AT8gLxGoA3WjTPyYkELkVVrMjt3vpoS0wj_ZgwUDt6uo_4k55hiUdbAtI00O0lu5iiD55-DdlNxY4hTUh38TZkuukPdwK8C59bV1JGukFMrppr5ncsV4t9H_zkZvYleTbYA4ZX9-cp-XZ-drn9xHZfLj5vNzvmFEBhXGqrufQyODl46Nxge2FbqZt-cJLbVgWlpXMglQfwXds1yglrB6WGoZdKnpK3izfVOgZdLMFduTSOwRUjRKfW7ZpX6t1C3eT0awpYzDGiC4fD0tMIWHMtoAP-KHxAr9OUx9phpmZOi5niC-VyQsxhMDe5_mb-YziYeTqzTGfqdGaezsyZN_fmqT8G_5D4t1UFxAJgvRp_hPz49P-tfwF4SaLV</recordid><startdate>20181201</startdate><enddate>20181201</enddate><creator>McCarthy, Colin J.</creator><creator>Kilcoyne, Aoife</creator><creator>Li, Xinhua</creator><creator>Cahalane, Alexis M.</creator><creator>Liu, Bob</creator><creator>Arellano, Ronald S.</creator><creator>Uppot, Raul N.</creator><creator>Gee, Michael S.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>20181201</creationdate><title>Radiation Dose and Risk Estimates of CT-Guided Percutaneous Liver Ablations and Factors Associated with Dose Reduction</title><author>McCarthy, Colin J. ; Kilcoyne, Aoife ; Li, Xinhua ; Cahalane, Alexis M. ; Liu, Bob ; Arellano, Ronald S. ; Uppot, Raul N. ; Gee, Michael S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-138a813d3ec3fd07cfab2a6385bfc31a64e483cc034d00d76754c2aaf44ffb343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>ABLATION</topic><topic>Ablation Techniques - methods</topic><topic>Aged</topic><topic>Cardiology</topic><topic>Clinical Investigation</topic><topic>Clinical Protocols</topic><topic>Complications</topic><topic>CT-GUIDED RADIOTHERAPY</topic><topic>Demographics</topic><topic>Demography</topic><topic>EFFECTIVE RADIATION DOSES</topic><topic>Electroporation</topic><topic>Exposure</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Imaging</topic><topic>Intravenous administration</topic><topic>Lesions</topic><topic>LIVER</topic><topic>Liver cancer</topic><topic>Liver Neoplasms - surgery</topic><topic>Male</topic><topic>Malignancy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>NEOPLASMS</topic><topic>Nuclear Medicine</topic><topic>PATIENTS</topic><topic>Radiation Dosage</topic><topic>Radiation effects</topic><topic>Radiation Exposure - statistics & numerical data</topic><topic>RADIATION HAZARDS</topic><topic>Radiation Protection</topic><topic>Radio frequency</topic><topic>Radiography, Interventional - methods</topic><topic>Radiology</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk Assessment - methods</topic><topic>Risk factors</topic><topic>Skin</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Tumors</topic><topic>Ultrasound</topic><topic>Weight</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McCarthy, Colin J.</creatorcontrib><creatorcontrib>Kilcoyne, Aoife</creatorcontrib><creatorcontrib>Li, Xinhua</creatorcontrib><creatorcontrib>Cahalane, Alexis M.</creatorcontrib><creatorcontrib>Liu, Bob</creatorcontrib><creatorcontrib>Arellano, Ronald S.</creatorcontrib><creatorcontrib>Uppot, Raul N.</creatorcontrib><creatorcontrib>Gee, Michael S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>Cardiovascular and interventional radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McCarthy, Colin J.</au><au>Kilcoyne, Aoife</au><au>Li, Xinhua</au><au>Cahalane, Alexis M.</au><au>Liu, Bob</au><au>Arellano, Ronald S.</au><au>Uppot, Raul N.</au><au>Gee, Michael S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Radiation Dose and Risk Estimates of CT-Guided Percutaneous Liver Ablations and Factors Associated with Dose Reduction</atitle><jtitle>Cardiovascular and interventional radiology</jtitle><stitle>Cardiovasc Intervent Radiol</stitle><addtitle>Cardiovasc Intervent Radiol</addtitle><date>2018-12-01</date><risdate>2018</risdate><volume>41</volume><issue>12</issue><spage>1935</spage><epage>1942</epage><pages>1935-1942</pages><issn>0174-1551</issn><eissn>1432-086X</eissn><abstract>Purpose
To determine the radiation dose associated with CT-guided percutaneous liver ablations and identify potential risk factors that result in higher radiation doses.
Materials and Methods
Between June 2011 and June 2015, 245 consecutive patients underwent 304 CT-guided liver ablation treatments. Patient demographics, tumor characteristics and procedural parameters were identified and analyzed. The peak skin dose and effective dose were assessed for each procedure. Excess relative risk related to radiation effects was calculated. A logistic regression model was prepared by means of stepwise logistic regression to identify variables predictive of increased radiation exposure.
Results
Tumor ablations were performed with microwave (
n
= 220), radiofrequency (
n
= 74) or irreversible electroporation (IRE) (
n
= 10). The mean peak skin dose for ablations was 239.2 ± 136.4 mGy, and the mean effective dose was 36.6 ± 22.3 mSv. Of the patient and procedural parameters that were analyzed, increasing weight, use of intravenous contrast and/or hydrodissection during the procedure, together with treatment of multiple lesions in the same sitting were all associated with higher radiation exposure. The mean increase in the absolute risk of fatal malignancy from a single procedure was 0.18% (range 0.02–0.9%). No deterministic skin changes were identified in the patient cohort.
Conclusion
The overall risk of stochastic and deterministic effects from radiation associated with CT-guided ablations is low compared with other inherent procedural complications. This study identifies several factors that are associated with higher radiation dose in percutaneous liver ablation procedures.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>30132100</pmid><doi>10.1007/s00270-018-2066-1</doi><tpages>8</tpages></addata></record> |
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| ispartof | Cardiovascular and interventional radiology, 2018-12, Vol.41 (12), p.1935-1942 |
| issn | 0174-1551 1432-086X |
| language | eng |
| recordid | cdi_osti_scitechconnect_22749691 |
| source | MEDLINE; SpringerLink Journals |
| subjects | ABLATION Ablation Techniques - methods Aged Cardiology Clinical Investigation Clinical Protocols Complications CT-GUIDED RADIOTHERAPY Demographics Demography EFFECTIVE RADIATION DOSES Electroporation Exposure Female Health risk assessment Humans Imaging Intravenous administration Lesions LIVER Liver cancer Liver Neoplasms - surgery Male Malignancy Medicine Medicine & Public Health Middle Aged NEOPLASMS Nuclear Medicine PATIENTS Radiation Dosage Radiation effects Radiation Exposure - statistics & numerical data RADIATION HAZARDS Radiation Protection Radio frequency Radiography, Interventional - methods Radiology RADIOLOGY AND NUCLEAR MEDICINE Retrospective Studies Risk analysis Risk Assessment - methods Risk factors Skin Tomography, X-Ray Computed - methods Tumors Ultrasound Weight |
| title | Radiation Dose and Risk Estimates of CT-Guided Percutaneous Liver Ablations and Factors Associated with Dose Reduction |
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