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

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 overcom...

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Main Authors: 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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Language:English
Published: MDPI AG 2024-11-01
Series:Tomography
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Online Access:https://www.mdpi.com/2379-139X/10/11/129
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author Michael P. Brönnimann
Mauro Tarca
Laura Segger
Jagoda Kulagowska
Florian N. Fleckenstein
Bernhard Gebauer
Uli Fehrenbach
Federico Collettini
Johannes T. Heverhagen
Timo A. Auer
author_facet Michael P. Brönnimann
Mauro Tarca
Laura Segger
Jagoda Kulagowska
Florian N. Fleckenstein
Bernhard Gebauer
Uli Fehrenbach
Federico Collettini
Johannes T. Heverhagen
Timo A. Auer
author_sort Michael P. Brönnimann
collection DOAJ
description 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 (<i>p</i> < 0.001). PRG with RT-CTF guidance was significantly faster than PRG with MS-CT BM, with an average difference of 10.28 min (<i>p</i> < 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; <i>p</i> = 0.463). Complication rates did not differ significantly either (<i>p</i> = 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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spelling doaj-art-ff7df0e078a44f9ca08917e082cfdfce2025-08-20T01:54:08ZengMDPI AGTomography2379-13812379-139X2024-11-0110111754176610.3390/tomography10110129Comparative Analysis of CT Fluoroscopy Modes and Gastropexy Techniques in CT-Guided Percutaneous Radiologic GastrostomyMichael P. Brönnimann0Mauro Tarca1Laura Segger2Jagoda Kulagowska3Florian N. Fleckenstein4Bernhard Gebauer5Uli Fehrenbach6Federico Collettini7Johannes T. Heverhagen8Timo A. Auer9Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010 Bern, SwitzerlandFaculty of Medicine, University of Bern, Murten Street, 3008 Bern, SwitzerlandDepartment of Radiology, Charité—Universitätsmedizin, Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010 Bern, SwitzerlandDepartment of Radiology, Charité—Universitätsmedizin, Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Radiology, Charité—Universitätsmedizin, Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Radiology, Charité—Universitätsmedizin, Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Radiology, Charité—Universitätsmedizin, Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010 Bern, SwitzerlandDepartment of Radiology, Charité—Universitätsmedizin, Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyBackground/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 (<i>p</i> < 0.001). PRG with RT-CTF guidance was significantly faster than PRG with MS-CT BM, with an average difference of 10.28 min (<i>p</i> < 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; <i>p</i> = 0.463). Complication rates did not differ significantly either (<i>p</i> = 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.https://www.mdpi.com/2379-139X/10/11/129gastrostomyradiation dosageradiographyinterventionaltomographyoperative time
spellingShingle Michael P. Brönnimann
Mauro Tarca
Laura Segger
Jagoda Kulagowska
Florian N. Fleckenstein
Bernhard Gebauer
Uli Fehrenbach
Federico Collettini
Johannes T. Heverhagen
Timo A. Auer
Comparative Analysis of CT Fluoroscopy Modes and Gastropexy Techniques in CT-Guided Percutaneous Radiologic Gastrostomy
Tomography
gastrostomy
radiation dosage
radiography
interventional
tomography
operative time
title Comparative Analysis of CT Fluoroscopy Modes and Gastropexy Techniques in CT-Guided Percutaneous Radiologic Gastrostomy
title_full Comparative Analysis of CT Fluoroscopy Modes and Gastropexy Techniques in CT-Guided Percutaneous Radiologic Gastrostomy
title_fullStr Comparative Analysis of CT Fluoroscopy Modes and Gastropexy Techniques in CT-Guided Percutaneous Radiologic Gastrostomy
title_full_unstemmed Comparative Analysis of CT Fluoroscopy Modes and Gastropexy Techniques in CT-Guided Percutaneous Radiologic Gastrostomy
title_short Comparative Analysis of CT Fluoroscopy Modes and Gastropexy Techniques in CT-Guided Percutaneous Radiologic Gastrostomy
title_sort comparative analysis of ct fluoroscopy modes and gastropexy techniques in ct guided percutaneous radiologic gastrostomy
topic gastrostomy
radiation dosage
radiography
interventional
tomography
operative time
url https://www.mdpi.com/2379-139X/10/11/129
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