Ultrasound-assisted catheter placement in CT-guided HDR brachytherapy for the local ablation of abdominal malignancies: Initial experience

Abstract

Purpose To evaluate the safety and feasibility of sonographically-assisted catheter placement in interstitial high-dose-rate brachytherapy of abdominal malignancies. Materials and Methods In an initial cohort of 12 patients and 16 abdominal tumors (colorectal liver metastases n=9; renal cell cancer n=3; hepatocellular carcinoma n=2; cholangiocellular carcinoma n=2), initial puncture and catheter placement for CT-guided brachytherapy were performed under sonographic assistance when possible. The interventional procedure was prospectively recorded and in-patient data were collected. All data underwent descriptive statistics and comparative analysis by the Mann-Whitney test. Results In 12 out of 16 lesions (diameter 1.5-12.9cm), initial puncture was successfully achieved under ultrasound guidance without utilization of CT fluoroscopy, yielding a significantly shorter mean total fluoroscopy time (14.5 vs. 105.5s; p=0.006). In 8 lesions visibility was rated better in ultrasound than in CT fluoroscopy (p=0.2). No major or minor complications occurred within 30 days after treatment. Conclusion Ultrasound-assisted catheter placement during interstitial CT-guided brachytherapy of abdominal tumors could improve catheter positioning and reduce radiation exposure for medical staff. Key points Ultrasound-assisted catheter placement in CT-guided brachytherapy is safe and feasible. Ultrasound puncture may improve catheter positioning. Reduced CT fluoroscopy time can significantly help to minimize radiation exposure for medical staff. Citation Format Damm R, El-Sanosy S, Omari J etal. Ultrasound-assisted catheter placement in CT-guided HDR brachytherapy for the local ablation of abdominal malignancies: Initial experience. Fortschr Röntgenstr 2019; 191: 48-53.