Next Level in Computed Tomography-Guided Periradicular Infiltration Therapy: Same Efficiency with Less Radiation Exposure

-OBJECTIVE: This retrospective cohort study investigated the radiation exposure and clinical efficiency of a new institutional low-dose protocol for computed tomography (CT)-guided lumbar periradicular infiltration (PRI).-METHODS: This was a retrospective matched-pair comparison of patients undergoing single-level lumbar PRI therapy employing a new low-dose CT protocol con-sisting of a helical scan with reduced energy levels and tube current versus the institutional standard CT protocol. The following variables were collected: dose-length product for the planning step, interventional step, and to -tal examination, number of CT guidance scans, examina-tion time, and postprocedural improvement on the -umerical rating scale for radicular pain.-RESULTS: Forty-five patients were allocated to each group. A sufficient radiation dose reduction of 30% during PRI was achieved with the low-dose protocol with a me-dian dose-length product of 9.8 mGy*cm compared to 32.9 mGy*cm with the standard protocol (P < 0.001). No need for additional multiple scans during the interventional mode was observed in the low-dose group, resulting in a comparable procedure time between the groups. Further-more, the short-term pain-reducing effect of PRI was comparable between the low-dose and standard protocols (median delta numerical rating scale [ 4 in both groups).-CONCLUSIONS: Our low-dose protocol with less tube voltage and lower electric current leads to less radiation exposure with the same safety and efficiency. In conclu-sion, every facility that performs CT-based procedures should check whether a further dose reduction is appli-cable to avoid stochastic radiation damage to the patient.

Automated summary

This study investigated the radiation exposure and clinical efficiency of a new low-dose protocol for CT-guided lumbar PRI. The low-dose protocol achieved a 30% reduction in radiation dose compared to the standard protocol, with comparable procedure time and pain-reducing effect.