title: Percutaneous cryoablation of renal masses under CT fluoroscopy: radiation doses to the patient and interventionalist.
abstract: OBJECTIVE
  Computed tomographic (CT) fluoroscopy-guided percutaneous cryoablation is an effective therapeutic method used to treat focal renal masses. The purpose of this study is to quantify the radiation dose to the patient and interventional radiologist during percutaneous cryoablation of renal masses using CT fluoroscopic guidance.
  
  
  METHODS
  Over a 1-year period, the CT fluoroscopy time during percutaneous cryoablation of renal masses was recorded in 41 patients. The level of complexity of each procedure was designated as simple, intermediate, or complex. Patient organ radiation doses were estimated using an anthropomorphic model. Dose to the interventional radiologist was estimated using ion chamber survey meters.
  
  
  RESULTS
  The average CT fluoroscopy time for technically simple cases was 47 s, 126 s for intermediate cases, and 264 s for complex cases. The relative risk of hematologic stomach and liver malignancy in patients undergoing this procedure was 1.003-1.074. The lifetime attributable risk of cancer ranged from 2 to 58, with the highest risk in younger patients for developing leukemia. The estimated radiation dose to the interventionalist without lead shielding was 390 mR (3.9 mGy) per year of cases.
  
  
  CONCLUSIONS
  The radiation risk to the patient during CT fluoroscopy-guided percutaneous renal mass cryoablation is, as expected, related to procedure complexity. Quantification of patient organ radiation dose was estimated using an anthropomorphic model. This information, along with the associated relative risk of malignancy, may assist in evaluating risks of the procedure, particularly in younger patients. The radiation dose to the interventionist is low regardless of procedure complexity, but highlights the importance of lead shielding.
authors.affiliation: Department of Radiology, Duke University Hospital, Box 3808, DUMC, Durham, NC, 27710, USA. jessica.stewart@dm.duke.edu.
authors.forename: Jessica K
authors.initials: JK
authors.lastname: Stewart
authors.affiliation: Department of Radiology, Duke University Hospital, Box 3808, DUMC, Durham, NC, 27710, USA.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Looney
authors.affiliation: Department of Radiology, Duke University Hospital, Box 3808, DUMC, Durham, NC, 27710, USA.
authors.forename: Colin D
authors.initials: CD
authors.lastname: Anderson-Evans
authors.affiliation: Department of Radiology, Duke University Hospital, Box 3808, DUMC, Durham, NC, 27710, USA.
authors.forename: Greta I
authors.initials: GI
authors.lastname: Toncheva
authors.affiliation: Department of Radiology, Duke University Hospital, Box 3808, DUMC, Durham, NC, 27710, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Sopko
authors.affiliation: Department of Radiology, Duke University Hospital, Box 3808, DUMC, Durham, NC, 27710, USA.
authors.forename: Charles Y
authors.initials: CY
authors.lastname: Kim
authors.affiliation: Department of Radiology, Duke University Hospital, Box 3808, DUMC, Durham, NC, 27710, USA.
authors.forename: Terry T
authors.initials: TT
authors.lastname: Yoshizumi
authors.affiliation: Department of Radiology, Duke University Hospital, Box 3808, DUMC, Durham, NC, 27710, USA.
authors.forename: Rendon C
authors.initials: RC
authors.lastname: Nelson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003452:Cryosurgery; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000601:surgery; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D015641:Radiography, Interventional; D012306:Risk; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: CT fluoroscopy; Cryoablation; Radiation dose