title: Radiation dose during CT-guided percutaneous cryoablation of renal tumors: Effect of a dose reduction protocol.
abstract: OBJECTIVE
  To estimate and compare the radiation dose using a standard protocol and that of a dose reduction protocol in patients undergoing CT-guided percutaneous cryoablation of renal tumors.
  
  
  METHODS
  An IRB-approved, HIPAA-compliant retrospective study of 97 CT-guided cryoablation procedures to treat a solitary renal tumor in each of 97 patients (64 M, 33 F; range 31-84 yrs) was performed. Fifty patients were treated using a standard dose protocol (kVp=120, mean mAs=180, monitoring scans every 3 min during freezes), and an additional 47 patients were treated using a dose reduction protocol (kVp=100, mean mAs=100, monitoring scans less frequently than every 3 min during freezes). Multiple Wilcoxon Mann-Whitney (rank-sum) tests were used to compare dose-length product (DLP) between the two groups. Fisher's exact test was used to compare technique effectiveness at 12 months post ablation between the two groups.
  
  
  RESULTS
  Median DLP for the standard protocol group was 4833.5 mGy*cm (range, 1667-8267 mGy*cm); median DLP for the dose reduction group was 2648 mGy*cm (range, 850-7169 mGy*cm), significantly less than that of the standard protocol group (p<0.01). The technique effectiveness for the dose reduction group was not significantly different from that of the standard protocol group at 12 month follow up (p=0.434).
  
  
  CONCLUSIONS
  The radiation dose during percutaneous CT-guided cryoablation of renal tumors was substantial in both the standard and the dose reduction groups; however, it was significantly lower with the protocol change that reduced dose parameters and decreased the number of CT scans.
authors.affiliation: Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. Electronic address: vlevesque1@partners.org.
authors.forename: Vincent M
authors.initials: VM
authors.lastname: Levesque
authors.affiliation: Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Shyn
authors.affiliation: Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: Kemal
authors.initials: K
authors.lastname: Tuncali
authors.affiliation: Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: Servet
authors.initials: S
authors.lastname: Tatli
authors.affiliation: Department of Radiology, Brigham & Women's Hospital, Boston, MA 02115, USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Nawfel
authors.affiliation: Department of Radiology, Brigham & Women's Hospital, Boston, MA 02115, USA.
authors.forename: Olutayo
authors.initials: O
authors.lastname: Olubiyi
authors.affiliation: Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: Stuart G
authors.initials: SG
authors.lastname: Silverman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D003452:Cryosurgery; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000601:surgery; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D015641:Radiography, Interventional; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed
keywords: CT-guidance; Cryoablation; Dose reduction protocol; Radiation dose