Radiation Exposure Reduction of CT Fluoroscopy in Targeting Celiac Plexus for Neurolysis in Chronic Pain Management

Abstract Background: Conventional CT (Computed Tomography) guided celiac block is the most accurate method for celiac block guidance the lack of real time visualization, radiation exposure & time consuming call the need for real time CT fluoroscopy guidance which provide adequate real time needle localization and radiation exposure reduction to patient and medical staff. Aim of Study: Describe technical ways that the IR (Inter-vention Radiology) team can implement ALARA (As Low As Reasonably Achievable) concept focusing on patient, operator and staff, to reduce the amount of radiation used to conduct the procedure. Patients and Methods: This study was carried out on 30 adult patients suffering from chronic abdominal pain related to infiltrative or metastatic pancreatic cancer or HCC and pain not controlled by WHO analgesic step ladder. Guided with CT fluoroscopy Celiac plexus neurolysis is performed, maximum filling of the retro-pancreatic space with ethanol is an indication of sufficient neurolysis. Applying parameters to reduce radiation exposure dose in pre-procedure helical scanning as well as get use of safety parameters of CT fluoroscopy, the total radiation dose exposure was calculated from the patient dose report. Results: The technique was successfully performed in 30 patients (100%). The mean value of total CT radiation beam intensity used to perform the procedures DLP per celiac plexus was 46.2 mGy X cm. Conclusion: CT fluoroscopy guided celiac plexus block is an easy and safe method that affords excessive success rates, applying ALARA parameters during the CTF procedure markedly decrease the affected person radiation dose in contrast with use of conventional CT guidance.