Utilization of Hybrid Angiography-CT Suites in an Interventional Oncology Practice

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Purpose: To evaluate operational trends in an interventional oncology practice at a tertiary academic center before and after the addition of hybrid angiography–computed tomography (Angio-CT) rooms. Materials and Methods: The procedure volumes and types performed in the hybrid Angio-CT rooms were retrospectively collected from 2016 to 2020. Procedures were divided into categories, including arteriography, endovascular interventional oncology, ablation, venous intervention, non-vascular catheter placement (biliary, nephrostomy, gastrostomy, etc.), and osseous interventions. Procedural trends in the Angio-CT rooms and the frequencies of combination procedures that used both CT and angiography were assessed. Results: A major shift of catheter-based tumor-directed cases to Angio-CT rooms (69% vs 31% in Angio-only rooms) was observed. Amongst liver tumor–directed angiographic procedures, there was an increased rate of spiral CT imaging use (73%) in the Angio-CT rooms compared with cone-beam CT use (27%) prior to hybrid room conversion. Preferential use of Angio-CT was observed in bone augmentation procedures (77% vs 21% in CT-only and 2% in Angio-only with cone-beam CT capabilities) and complex non-oncologic vascular procedures (85% vs 15% in Angio-only with cone-beam CT capabilities). Angio-CT rooms were also commonly used to perform routine procedures such as percutaneous needle biopsies, fluid drainages, and biliary/renal/enteral tube placement and/or exchange cases, thus sharing scheduling load from other rooms. The number of concurrent (ie, liver ablation plus embolization) or consecutive (ie, inferior vena cava filter placement plus CT-guided drainage) procedures that utilized both CT and angiography progressively increased over each of the time periods evaluated. Conclusion: Hybrid Angio-CT procedure rooms with multimodality imaging capabilities serve as preferred rooms for a variety of tumor-directed and other increasingly complex procedures. In addition, these rooms can be used for routine image-guided biopsies and non-vascular procedures, thus providing flexibility and versatility in day-to-day operations in an interventional oncology practice.

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