Comparative Analysis of CT Fluoroscopy Modes and Gastropexy Techniques in CT-Guided Percutaneous Radiologic Gastrostomy
Michael P. Brönnimann,
Mauro Tarca,
Laura Segger,
Jagoda Kulagowska,
Florian N. Fleckenstein,
Bernhard Gebauer,
Uli Fehrenbach,
Federico Collettini,
Johannes T. Heverhagen,
Timo A. Auer
Affiliations
Michael P. Brönnimann
Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010 Bern, Switzerland
Mauro Tarca
Faculty of Medicine, University of Bern, Murten Street, 3008 Bern, Switzerland
Laura Segger
Department of Radiology, Charité—Universitätsmedizin, Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
Jagoda Kulagowska
Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010 Bern, Switzerland
Florian N. Fleckenstein
Department of Radiology, Charité—Universitätsmedizin, Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
Bernhard Gebauer
Department of Radiology, Charité—Universitätsmedizin, Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
Uli Fehrenbach
Department of Radiology, Charité—Universitätsmedizin, Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
Federico Collettini
Department of Radiology, Charité—Universitätsmedizin, Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
Johannes T. Heverhagen
Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010 Bern, Switzerland
Timo A. Auer
Department of Radiology, Charité—Universitätsmedizin, Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
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 (p p p = 0.463). Complication rates did not differ significantly either (p = 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.
