Evaluation of Patients’ Radiation Exposure in Neuroendovascular Therapy ─Estimated dose by questionnaire investigation─

Imazeki, Masaharu; Kawasaki, Kohei; Hasegawa, Ryota; Takahashi, Hiroyuki; Suzuki, Hiroaki; Sato, Kazuhiko; Oota, Joji; Awai, Kazuo; Kobayashi, Shigeki; Abe, Toshi; Ono, Junichi; Sakamoto, Hajime; Tajima, O.; Tsukamoto, Atsuko; Kikuchi, Tatsuya; Kageyama, Takahiro; Kato, K.

doi:10.5797/jnet.13019

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…Regarding the purpose of examination by CA, only the target blood vessel was imaged during follow-up examination after treatment in several cases and these were excluded. Moreover, it has been reported that the radiation dose during treatment of arteriovenous shunt diseases, such as cerebral arteriovenous malformation and dural arteriovenous fistula, is higher than that in other diseases, 3 , 4) suggesting that the radiation dose increases during examination compared with that in the other diseases, and thus these cases were also excluded. In the 496 patients in this study, the median FT and AK were 10.5 min and 342.5 mGy, respectively, being comparable with those in previous reports.…”

Section: Discussionmentioning

confidence: 99%

Investigation of Fluoroscopy Time and Radiation Dose by the Number of Cerebral Angiography Operator Experiences

Niimi

Nakamura

Ueda

et al. 2022

JNET

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We investigated the fluoroscopy time (FT) and radiation dose by the number of cerebral angiography (CA) operator experiences to clarify the learning curve of CA. Methods:The subjects were cases for whom CA was performed at our hospital for 5 years between April 2015 and March 2020. Based on the number of CA operator experiences, they were classified into four groups: 1-50 cases (group A), 51-100 cases (group B), 101-200 cases (group C), and 201 cases and later (group D). The FT and radiation dose were retrospectively investigated.Results: Of the 865 consecutive CA cases, 293 cases for follow-up, i.e. after treatment, 54 for arteriovenous shunt diseases, 21 lacking data, and 1 case requiring intervention for thrombosis during CA were excluded. In total, 496 CA cases were investigated. There were 61 cases in group A, 56 cases in group B, 44 cases in group C, and 335 cases in group D, and there was no significant difference in patient background factors among the groups. The median FT and radiation dose (interquartile range) in each group were 20.2 min (14.6) and 374 mGy (185.3) in group A, 14.8 min (12.1) and 366 mGy (167.9) in group B, 10.8 min (6) and 320 mGy (151.7) in group C, and 9.4 min (6.4) and 336 mGy (171) in group D. The FT was significantly shorter in group C than in group A, and significantly shorter in group D than in groups A, B, and C. The radiation dose was significantly lower in groups C and D than in groups A and B. Conclusion:This study suggested that CA can be performed alone after experiencing approximately 100 cases as an operator.

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Section: Discussionmentioning

confidence: 99%

Investigation of Fluoroscopy Time and Radiation Dose by the Number of Cerebral Angiography Operator Experiences

Niimi

Nakamura

Ueda

et al. 2022

JNET

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“…Since the absorption is higher in clinical subjects than in the phantom used in this study, the dose is considered to increase in both low-and high-voltage imaging. There is a report that the estimated exposure of the lens along the X-axis during intracranial endovascular treatment was about 0.91 Gy, which is markedly higher than the threshold for the lens, 12) and CBCT is also considered useful for the control of additional lens exposure by postprocedural CT.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Estimated Exposure of the Lens Due to Cone-beam CT and Area Detector CT

Shimada

Kofune

Nagatsuka

et al. 2018

JNET

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Objective: Recently, the exposure threshold for cataract has been reduced, and interest in lens exposure is deepening.The importance of cone-beam CT (CBCT) is increasing in the field of intracranial endovascular treatment, and opportunities of substituting CT after endovascular treatment with CBCT has also increased. While the exposure by angiography and CT must be considered comprehensively for the management of lens exposure, total dose management and direct comparison are difficult due to the difference in the evaluation methods. Therefore, we compared the direct doses measured at the lens between the modalities. Methods:We measured the doses at five points (center, upper, lower, left, and right) in an acrylic phantom 16 cm in diameter and simulating the head for the determination of the CT dose index (CTDI) under various conditions of nonhelical scanning of area detector CT (ADCT) and CBCT and compared the mean of the five points, which was assumed to be the dose of the whole head, and the upper point, which was assumed to correspond to the lens. Results:The ratio of the dose by ADCT relative to that by 15-second MIDDLE mode CBCT was 1.1 as the mean of the five sites but was 2.3 at the site corresponding to the lens. Conclusion:Compared with CT, by which the object is scanned over 360°, the exposure of the lens can be reduced by CBCT because it collects data from an arc of dorsal 200° and does not directly apply X-ray to the lens.

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“…In a multicenter study conducted in Japan, the mean treatment time was 172.6 min for cerebral aneurysms, 179.2 min for cerebral arteriovenous malformation, 309.2 min for cavernous sinus dural arteriovenous fistulas, 291.1 min for other dural arteriovenous fistulas, and 190 min for all diseases combined. The treatment has been reported to require an average of more than 3 h. 1) At our facility, the angiographic system was updated to SIEMENS Artiszee BA Twin (Siemens, Munich, Germany) in February 2012. Conventionally, the fixation device accompanying the angiographic system (conventional fixation device) was used for head fixation during endovascular therapy under general anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Head Fixation Using a Vac-Lok Cushion during Neuroendovascular Therapy

Uesaka

Miyakoshi

Ando

et al. 2016

JNET

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Objective: Vac-Lok cushions are widely used in the field of radiation therapy to fix a body in place. We introduced this device during neuroendovascular therapy and evaluated its utility in comparison with a conventional device. Methods:We conducted questionnaire surveys regarding post-procedural headache among patients and regarding advantages and disadvantages of the new fixation device among radiation technologists and neurosurgeons. We measured the contact pressures of volunteers' heads to compare stress on the head between the two devices.Results: Contact pressure significantly decreased using the new device. Furthermore, complaints regarding post-procedural headache sharply declined after introducing the new device. The new device also reduces respiratory motion artifacts and allows the head to be positioned at any angle we want. Conclusion:The Vac-Lok cushion is extremely useful for fixing the head in place during neuroendovascular therapy.

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Evaluation of Patients’ Radiation Exposure in Neuroendovascular Therapy ─Estimated dose by questionnaire investigation─

Cited by 4 publications

References 5 publications

Investigation of Fluoroscopy Time and Radiation Dose by the Number of Cerebral Angiography Operator Experiences

Investigation of Fluoroscopy Time and Radiation Dose by the Number of Cerebral Angiography Operator Experiences

Evaluation of Estimated Exposure of the Lens Due to Cone-beam CT and Area Detector CT

Head Fixation Using a Vac-Lok Cushion during Neuroendovascular Therapy

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