Characteristics of a New X-Ray Imaging System for Interventional Procedures: Improved Image Quality and Reduced Radiation Dose

Abstract

PurposeTo compare image quality and radiation exposure between a new angiographic imaging system and the preceding generation system during uterine artery embolization (UAE).Materials and MethodsIn this retrospective, IRB-approved two-arm study, 54 patients with symptomatic uterine fibroids were treated with UAE on two different angiographic imaging systems. The new system includes optimized acquisition parameters and real-time image processing algorithms. Air kerma (AK), dose area product (DAP) and acquisition time for digital fluoroscopy (DF) and digital subtraction angiography (DSA) were recorded. Body mass index was noted as well. DF image quality was assessed objectively by image noise measurements. DSA image quality was rated by two blinded, independent readers on a four-rank scale. Statistical differences were assessed with unpaired t tests and Wilcoxon rank-sum tests.ResultsThere was no significant difference between the patients treated on the new (n = 36) and the old system (n = 18) regarding age (p = 0.10), BMI (p = 0.18), DF time (p = 0.35) and DSA time (p = 0.17). The new system significantly reduced the cumulative AK and DAP by 64 and 72%, respectively (median 0.58 Gy and 145.9 Gy*cm2 vs. 1.62 Gy and 526.8 Gy*cm2, p < 0.01 for both). Specifically, DAP for DF and DSA decreased by 59% (75.3 vs. 181.9 Gy*cm2, p < 0.01) and 78% (67.6 vs. 312.2 Gy*cm2, p < 0.01), respectively. The new system achieved a significant decrease in DF image noise (p < 0.01) and a significantly better DSA image quality (p < 0.01).ConclusionsThe new angiographic imaging system significantly improved image quality and reduced radiation exposure during UAE procedures.Electronic supplementary materialThe online version of this article (doi:10.1007/s00270-017-1821-z) contains supplementary material, which is available to authorized users.

Radiation dose reduction capabilities of a new C-arm system with optimized hard- and software

“…This technique was reported to facilitate a significant radiation dose reduction of both digital fluoroscopy (DF) and digital subtraction angiography (DSA) for various image-guided procedures in the field of interventional radiology Abbreviations: AK, Air kerma; BMI, Body Mass Index; DAP, Dose area product; DEB-TACE, Drug-eluting Bead chemoembolization; DF, Digital fluoroscopy; DSA, Digital subtraction angiography; DSA-DAP, Digital subtraction angiography dose area product; HU, Heat Units; PACS, Picture Archiving and Communication System; RAK, Reference air kerma; RDSR, Radiation Dose Structured Reports; SID, Source-to-Image Receptor Distance; TACE, Transarterial chemoembolization. [13][14][15] and interventional cardiology [16,17].…”

Digital Variance Angiography in Lower-Limb Angiography with Metal Implants

“…Lowering the radiation or ICM dose normally results in reduced image quality. Noise reduction algorithms are reported to provide a possible solution in this regard [ 8 , 11 ].…”

The factors contributing to the total radiation exposure of patients during uterine artery embolisation

“…Another study by Mondshine et al also found that the technology was associated with a decreased cumulative dose (0.78 Gy) and skin DAPs (146.35 Gy cm 2 ) on their flat–panel angiography system (Axiom Artis, Siemens Medical Systems, Germany). Recent literature by Schernthaner et al , published in 2018 supports previous findings that the flat–panel angiography units produce significantly improved image quality and reduced radiation exposure. These benefits further justify the clinical viability of UAE as a non‐invasive procedure and offset any potential, but rare, risks that may be involved with this technique …”