Cone-beam computed tomography (CBCT) is a widely used imaging technique in interventional radiology. Although CBCT offers great advantages in terms of improving comprehension of complex angioarchitectures and guiding therapeutic decisions, its additional degree of radiation exposure has also aroused considerable concern. In this study, we aimed to assess radiation exposure and its influential factors in patients undergoing CBCT scans of the head and abdomen during interventional procedures. A total of 752 patients were included in this retrospective study. Dose area product (DAP) and reference air kerma (RAK) were used as measures of patient dose. The results showed that the median values of DAP were 53.8 (50.5–64.4) Gy⋅cm² for head CBCT and 47.4 (39.6–54.3) Gy⋅cm² for that of the abdomen. Male gender and body mass index (BMI) were characterized by increased DAP and RAK values in both head and abdominal CBCT scans. Larger FOV size was associated with a higher DAP but a lower RAK value, especially in head CBCT scans. Exposure parameters under automatic exposure control (AEC) also varied according to patient BMI and gender. In conclusion, the patients received slightly higher radiation doses from head CBCT scans than from those applied to the abdomen. BMI, gender, and FOV size were the key factors that influenced the radiation dose administered to the patients during CBCT scans. Our results may help to define and minimize patients’ exposure to radiation.

Aland White rabbits were used to establish a VX2 liver tumor model. Hepatic artery angiography and embolization were performed 3 weeks after inoculation. The rabbits were restrained in supine position under anesthesia. Intra-arterial access was accomplished with percutaneous Seldinger technique through the auricular artery using a PICC device. The hepatic artery catheterization was performed with a microcatheter and guide wire. The rate of technical success and procedure time was investigated. Results: Two rabbits failed initial percutaneous transauricular arterial access, with success in a contralateral attempt. Thus, percutaneous transauricular arterial access was achieved in 10 of 12 auricular arteries, with a technical success rate of 83.3%. The time needed to obtain intra-auricular access was 7.2 ± 3.1 min. Hepatic artery catheterization, angiography, and embolization were accomplished through the auricular approach in all 10 rabbits. Conclusion: Arterial access in rabbits can be achieved through the auricular artery. Hepatic artery catheterization, angiography, and embolization can be performed through auricular arterial access....

Purpose: To analyze the efficacy and safety of the combination of transarterial chemoembolization (TACE) with percutaneous ethanol injection (PEI) in the treatment of hepatocellular carcinoma (HCC) at high-risk areas. Materials and Methods: Data from cases involving TACE combined with PEI for HCC treatment in high-risk regions were analyzed from January 2016 to December 2023 at three medical centers. High-risk areas were defined as those less than 10 mm from the diaphragm, gallbladder, gastrointestinal tract, or secondary branches of the portal vein or bile duct. The guidance modalities for PEI were computed tomograph (CT) and cone beam computed tomograph (CBCT). Each lesion received only one session of TACE combined with PEI. Treatment efficacy was assessed by complete ablation rate of target lesions at the 2-month follow-up. Factors affecting the efficacy were determined by binary logistic regression analysis. The difference in efficacy between CT-guided and CBCT-guided PEI was analyzed by Chi-square test. Results: About 62 patients with 67 target lesions were included in the analysis. The overall complete ablation rate lesion-based was 80.6% (54/67). Lesion diameter was significantly associated with the probability of achieving complete ablation (OR = 6.89, 95% CI: 1.57–30.234, P = 0.011). There was no significant difference in the complete ablation rates between CT- and CBCT-guided approaches (83.3% vs. 80%, P = 0.867). No severe complications occurred during treatment or follow-up. Conclusion: The combination of TACE with a single PEI proves to be a safe and effective treatment for HCC in high-risk areas. There was no difference between CBCT-guided and CT-guided outcomes.