Comparative Analysis of CT Fluoroscopy Modes and Gastropexy Techniques in CT-Guided Percutaneous Radiologic Gastrostomy.

IF 2.2 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Tomography Pub Date : 2024-11-06 DOI:10.3390/tomography10110129

Michael P Brönnimann, Mauro Tarca, Laura Segger, Jagoda Kulagowska, Florian N Fleckenstein, Bernhard Gebauer, Uli Fehrenbach, Federico Collettini, Johannes T Heverhagen, Timo A Auer

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Abstract

Background/objectives: This study was conducted to compare two modes of computed tomography fluoroscopy (CTF) and two gastropexy techniques used in CT-guided percutaneous radiologic gastrostomy (CT-PRG) aiming to identify the optimal techniques for image guidance and gastropexy and, thus, to overcome the current lack of consensus on the preferred modalities.

Methods: We retrospectively identified 186 successful CT-PRG procedures conducted evenly across two university hospitals from January 2019 to December 2023. Patients were divided into two groups (intermittent multislice CT biopsy mode-guided technique (MS-CT BM) and retention anchor suture (T-fastener) versus real-time (RT-)CTF and gastropexy device) for descriptive analysis of demographics, indication for PRG, radiation exposure (DLP), procedural time, number of CT scans, gastropexy time, and complications. Differences were assessed for statistical significance using Fisher's exact test and the Mann-Whitney U-test.

Results: Our final study population comprised 100 patients (50 from each center; 62.52 ± 12.36 years, 73 men). There was a significant difference in radiation exposure between MS-CT BM (group 1) and RT-CTF (group 2), with an average dose-length product (DLP) of 56.28 mGycm×m ± 67.89 and 30.91 ± 27.53 mGycm×cm, respectively (p < 0.001). PRG with RT-CTF guidance was significantly faster than PRG with MS-CT BM, with an average difference of 10.28 min (p < 0.001). No significant difference in duration was found between the two gastropexy methods compared (retention anchor suture, 11.50 ± 5.239 s vs. gastropexy device, 11.17 ± 6.015 s; p = 0.463). Complication rates did not differ significantly either (p = 0.458).

Conclusions: Our findings indicate comparable efficacy and safety of the two gastropexy methods and underscore that the choice of CTF mode for image guidance has only a small role in reducing radiation exposure in patients undergoing CT-PRG. Instead, it is essential to avoid control scans.

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CT引导经皮放射胃造瘘术中CT透视模式与胃镜技术的对比分析

背景/目的：本研究对 CT 引导下经皮放射胃造瘘术（CT-PRG）中使用的两种计算机断层扫描透视（CTF）模式和两种胃切开术技术进行了比较，旨在确定图像引导和胃切开术的最佳技术，从而克服目前对首选模式缺乏共识的问题：我们回顾性地鉴定了两家大学医院在 2019 年 1 月至 2023 年 12 月期间成功实施的 186 例 CT-PRG 手术。患者被分为两组（间歇性多层 CT 活检模式引导技术（MS-CT BM）和保留锚缝合（T-固定器）与实时（RT-）CTF 和胃钉装置），对人口统计学、PRG 适应症、辐射暴露（DLP）、手术时间、CT 扫描次数、胃钉时间和并发症进行描述性分析。采用费雪精确检验和曼-惠特尼 U 检验评估差异的统计学意义：最终研究对象包括 100 名患者（每个中心 50 名；62.52 ± 12.36 岁，73 名男性）。MS-CT BM（第 1 组）和 RT-CTF（第 2 组）的辐射量有明显差异，平均剂量-长度乘积（DLP）分别为 56.28 mGycm×m ± 67.89 和 30.91 ± 27.53 mGycm×cm（P < 0.001）。使用 RT-CTF 引导的 PRG 明显快于使用 MS-CT BM 的 PRG，平均差异为 10.28 分钟（p < 0.001）。相比之下，两种胃镜方法的持续时间无明显差异（留置锚缝合，11.50 ± 5.239 秒 vs. 胃镜装置，11.17 ± 6.015 秒；p = 0.463）。并发症发生率也无明显差异（p = 0.458）：我们的研究结果表明，两种胃切除术方法的有效性和安全性相当，并强调选择 CTF 模式进行图像引导对减少 CT-PRG 患者的辐射暴露作用很小。相反，必须避免对照扫描。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Tomography Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

2.70

自引率

10.50%

发文量

222

期刊介绍： TomographyTM publishes basic (technical and pre-clinical) and clinical scientific articles which involve the advancement of imaging technologies. Tomography encompasses studies that use single or multiple imaging modalities including for example CT, US, PET, SPECT, MR and hyperpolarization technologies, as well as optical modalities (i.e. bioluminescence, photoacoustic, endomicroscopy, fiber optic imaging and optical computed tomography) in basic sciences, engineering, preclinical and clinical medicine. Tomography also welcomes studies involving exploration and refinement of contrast mechanisms and image-derived metrics within and across modalities toward the development of novel imaging probes for image-based feedback and intervention. The use of imaging in biology and medicine provides unparalleled opportunities to noninvasively interrogate tissues to obtain real-time dynamic and quantitative information required for diagnosis and response to interventions and to follow evolving pathological conditions. As multi-modal studies and the complexities of imaging technologies themselves are ever increasing to provide advanced information to scientists and clinicians. Tomography provides a unique publication venue allowing investigators the opportunity to more precisely communicate integrated findings related to the diverse and heterogeneous features associated with underlying anatomical, physiological, functional, metabolic and molecular genetic activities of normal and diseased tissue. Thus Tomography publishes peer-reviewed articles which involve the broad use of imaging of any tissue and disease type including both preclinical and clinical investigations. In addition, hardware/software along with chemical and molecular probe advances are welcome as they are deemed to significantly contribute towards the long-term goal of improving the overall impact of imaging on scientific and clinical discovery.