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Sci‐AM1 Sat ‐ 03: Comparison of chest radiographs, fluoroscopy and seed‐migration detector for the detection of embolized seeds to the lung
Author(s) -
Morrier J,
Chrétien M,
Beaulieu L
Publication year - 2005
Publication title -
medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.473
H-Index - 180
eISSN - 2473-4209
pISSN - 0094-2405
DOI - 10.1118/1.2031044
Subject(s) - fluoroscopy , radiography , medicine , chest radiograph , detector , radiology , flat panel detector , nuclear medicine , optics , physics
To evaluate the efficacy of a seed‐migration detector and to compare it to fluoroscopy and to the postoperative chest radiographs generally recommended. A gamma scintillation survey meter was converted to a seed‐migration detector. It was used to perform a chest evaluation on 155 patients (8717 seeds) at their first postoperative visit. When the detector showed activity around a patient's chest, it was confirmed by taking an antero‐posterior chest radiograph and by looking at the region with fluoroscopy. 3 patients (21.3%) present at least one embolized seed. That is a 0.47% seed migration rate (41/8717). 37 (90%) of the seeds were visible under fluoroscopy and 28 (68%) appeared on x‐rays. Rapid movement of the seeds, due to breathing or to a location close to the heart, makes nine seeds to be visible with fluoroscopy but not on the radiograph. Moreover, four seeds were not visible with fluoroscopy neither with radiograph. In comparison to the seed‐migration detector, detection based on fluoroscopy would have led to four false‐negative detections (out of 33 or 12.1%) while the radiograph would have resulted in thirteen or 39.4%. Moreover, x‐ray would have required extra radiation dose to lung to 100% of the patients rather than the 21.3% who needed it in this study. The recommendation to perform chest radiographs should be revised because of superior efficacy of the seed‐migration detector. X‐rays should only remain for documentation purposes. Finally, the detector is convenient, cost‐effective and non‐invasive: it does not require any additional radiation to the patient.