{"\ufeffMYSIR\u2019s Abstracts 1\nMalaysian Society of Interventional Radiology\n\nDOI: https://doi.org/10.32896/tij.v2n4.18-24\nPublished: 31.12.2022\nOP01\n\nCOMPARING EFFECTS OF C-ARM CONE BEAM CT AND HYBRID-CT/C-ARM SYSTEMS ON PATIENT RADIATION DOSE IN TRANSARTERIAL CHEMOEMBOLISATION PROCEDURES\nL. K. Jin1, W. F. K. Sheng2, C. J. M. S. Xavier2, L. Sum2\n1Lee Kong Chian School of Medicine, Nanyang Technological University-Imperial College London, Singapore 308232\n2Department of Vascular and Interventional Radiology, Singapore General Hospital, Outram Road, Singapore 169608\n\n\nBackground/Purpose:\nC-arm cone-beam computed tomography (CBCT) and hybrid-CT/C-arm are the two main systems used to perform transarterial chemoembolization (TACE). However CBCT poses certain disadvantages compared to hybrid-CT/C-arm such as smaller field-of-view and inconsistent anatomical detail. The study aims to further evaluate the difference in patient radiation dose between usage of CBCT and hybrid-CT/C-arm in TACE procedures.\n\nMaterials and Methods:\nTACE procedures performed between July 2016 and July 2022 were collected and grouped by imaging modality (3D-guided vs only 2D) and imaging system (C-arm CBCT vs hybrid CT/C-arm). Differences in patient characteristics and patient radiation dose were analysed. Kerma-area product (PKA) and dose-length product (DLP) were converted to effective dose (ED) for comparison. Reference air-kerma (Ka,r) was also collected.\n\nResults:\nA total of 378 procedures was analysed with 348 undergoing 3D-guided procedures and 30 undergoing 2D-guided procedures. Of the 3D-guided procedures, 176 were performed using C-arm CBCT and 172 were performed using hybrid-CT/C-arm. The total ED in the hybrid-CT/C-arm group was 1.5 times lower than in C-arm group (median 37.9 vs 55.3mSv, p<.001). Total KAP and Ka,r were both lower in the hybrid-CT/C-arm 3D group than the C-arm group (median 123.3 vs 248.3Gycm2, p<.001 and 1030 vs 1153mGy p": null, " 21.8 vs 8.53mSv, p": null, " p<0.001). Prescription of the recommended single dose 2g IV cefazolin for patients without high-risk factors increased after the guideline was implemented (40.0% vs. 97.8%). There were no ablation-related infections and mortality within 30 days post-ablation, and post-procedural nausea and vomiting were significantly reduced (15.4% vs. 1.9%": null, " p": "0.020). No significant difference in post-procedural fever (7.7% vs. 5.6%", " NATIONAL CANCER INSTITUTE\u2019S EXPERIENCE\nS. Ain1, A. R. Ridzuan1\n1Department of Radiology, National Cancer Institute, Putrajaya, Wilayah Persekutuan Putrajaya\n\nIntroduction:\nAdrenal Venous Sampling (AVS) is the gold standard test to identify sources of excess aldosterone. It is highly advisable to perform this procedure for a patient with Primary Aldosteronism. It can determine the overproduction of the aldosterone whether it is unilateral or bilateral. The test will provide a decisive treatment plan for the patient. A unilateral secretion can be surgically treated.\n\nCase Report:\nAVS procedure has a reputation as a challenging procedure and demands great skills of the Interventional Radiologist (IR). Sampling is performed from each adrenal vein together with peripheral samples using variation of catheter in sequential or simultaneous manner. Anatomically, the right adrenal vein originates directly from the inferior vena cava while the left adrenal vein originates from the left renal vein. Due to the anatomical structure, it is difficult to recognise the adrenal veins for selective cannulations. Technically, the right adrenal vein is more challenging to cannulate than the left adrenal vein. Multiple techniques and strategies are used by the IR to perform AVS procedure. In National Cancer Institute (NCI), Cone Beam CT is used during AVS procedure to aid the selective cannulation of the adrenal veins.\n\nConclusion:\nA conclusion of a successful AVS can be drawn by the level of the cortisol from the derived bloods. Since cortisol is only produced by adrenal glands, it is assumed that there is an increment of cortisol level in the adrenal veins compared with peripheral veins. The result will then be further used to calculate the lateralisation index. We are using this method since the year of 2020, the success rate of AVS sampling is 100%.": null}